Nucleic acid-polypeptide compositions and methods of inducing exon skipping

ABSTRACT

Disclosed herein are molecules and pharmaceutical compositions that induce an insertion, deletion, duplication, or alteration in an incorrectly spliced mRNA transcript to induce exon skipping or exon inclusion. Also described herein include methods for treating a disease or disorder that comprises a molecule or a pharmaceutical composition that induces an insertion, deletion, duplication, or alteration in an incorrectly spliced mRNA transcript to induce exon skipping or exon inclusion.

CROSS-REFERENCE

This application is a continuation of U.S. application Ser. No. 16/129,696, filed Sep. 12, 2018, which is a continuation of U.S. application Ser. No. 16/128,450 filed Sep. 11, 2018, which is a continuation of the International Application No. PCT/US2018/012672, filed Jan. 5, 2018, which claims the benefit of U.S. Provisional Patent Application No. 62/561,939 filed on Sep. 22, 2017 and 62/443,514 filed on Jan. 6, 2017, each of which is incorporated herein by reference in its entirety.

SEQUENCE LISTING

The instant application contains a Sequence Listing which has been submitted electronically in ASCII format and is hereby incorporated by reference in its entirety. Said ASCII copy, created on Sep. 12, 2018, is named 45532-715_304_SL.txt and is 210,679 bytes in size.

BACKGROUND OF THE DISCLOSURE

Modulation of RNA function is a developing area of therapeutic interest. Drugs that affect mRNA stability like antisense oligonucleotides and short interfering RNAs are one way to modulate RNA function. Another group of oligonucleotides can modulate RNA function by altering the processing of pre-mRNA to include or exclude specific regions of pre-mRNAs from the ultimate gene product: the encoded protein. As such, oligonucleotide therapeutics represent a means of modulating protein expression in disease states and as such have utility as therapeutics.

SUMMARY OF THE DISCLOSURE

Disclosed herein, in certain embodiments, are molecules and pharmaceutical compositions for modulating RNA processing.

Disclosed herein, in certain embodiments, are methods of treating a disease or disorder caused by an incorrectly spliced mRNA transcript in a subject in need thereof, the method comprising: administering to the subject a polynucleic acid molecule conjugate; wherein the polynucleic acid molecule conjugate is conjugated to a cell targeting binding moiety; wherein the polynucleotide optionally comprises at least one 2′ modified nucleotide, at least one modified internucleotide linkage, or at least one inverted abasic moiety; wherein the polynucleic acid molecule conjugate induces insertion, deletion, duplication, or alteration in the incorrectly spliced mRNA transcript to induce exon skipping or exon inclusion in the incorrectly spliced mRNA transcript to generate a fully processed mRNA transcript; and wherein the fully processed mRNA transcript encodes a functional protein, thereby treating the disease or disorder in the subject. In some embodiments, the disease or disorder is further characterized by one or more mutations in the mRNA. In some embodiments, the disease or disorder comprises a neuromuscular disease, a genetic disease, cancer, a hereditary disease, or a cardiovascular disease. In some embodiments, the disease or disorder is muscular dystrophy. In some embodiments, the disease or disorder is Duchenne muscular dystrophy. In some embodiments, the exon skipping is of exon 8, 23, 35, 43, 44, 45, 50, 51, 52, 53, or 55 of the DMD gene. In some embodiments, the exon skipping is of exon 23 of the DMD gene. In some embodiments, the polynucleic acid molecule conjugate comprises a structure of Formula (I): A-X-B   Formula I

-   -   wherein,     -   A comprises a binding moiety;     -   B consists of a polynucleotide; and     -   X consists of a bond or first linker.         In some embodiments, the polynucleic acid molecule conjugate         comprises a structure of Formula (II):         A-X-B-Y-C   Formula II     -   wherein,     -   A comprises a binding moiety;     -   B consists of a polynucleotide;     -   C consists of a polymer;     -   X consists of a bond or first linker; and     -   Y consists of a bond or second linker.         In some embodiments, the polynucleic acid molecule conjugate         comprises a structure of Formula (III):         A-X-C-Y-B   Formula III     -   wherein,     -   A comprises a binding moiety;     -   B consists of a polynucleotide;     -   C consists of a polymer;     -   X consists of a bond or first linker; and     -   Y consists of a bond or second linker.         In some embodiments, the at least one 2′ modified nucleotide         comprises a morpholino, 2′-O-methyl,         2′-O-methoxyethyl(2′-O-MOE), 2′-O-aminopropyl, 2′-deoxy,         T-deoxy-2′-fluoro, 2′-O-aminopropyl (2′-O-AP),         2′-O-dimethylaminoethyl (2′-O-DMAOE), 2′-O-dimethylaminopropyl         (2′-O-DMAP), T-O-dimethylaminoethyloxyethyl (2′-O-DMAEOE), or         2′-O—N-methylacetamido (2′-O-NMA) modified nucleotide. In some         embodiments, the at least one 2′ modified nucleotide comprises         locked nucleic acid (LNA), ethylene nucleic acid (ENA), or a         peptide nucleic acid (PNA). In some embodiments, the at least         one 2′ modified nucleotide comprises a morpholino. In some         embodiments, the at least one inverted basic moiety is at least         one terminus. In some embodiments, the at least one modified         internucleotide linkage comprises a phosphorothioate linkage or         a phosphorodithioate linkage. In some embodiments, the         polynucleic acid molecule is at least from about 10 to about 30         nucleotides in length. In some embodiments, the polynucleic acid         molecule is at least one of: from about 15 to about 30, from         about 18 to about 25, from about 18 to about 24, from about 19         to about 23, or from about 20 to about 22 nucleotides in length.         In some embodiments, the polynucleic acid molecule is at least         about 16, 17, 18, 19, 20, 21, 22, 23, 24, or 25 nucleotides in         length. In some embodiments, the polynucleic acid molecule         comprises at least one of: from about 5% to about 100%         modification, from about 10% to about 100% modification, from         about 20% to about 100% modification, from about 30% to about         100% modification, from about 40% to about 100% modification,         from about 50% to about 100% modification, from about 60% to         about 100% modification, from about 70% to about 100%         modification, from about 80% to about 100% modification, and         from about 90% to about 100% modification. In some embodiments,         the polynucleic acid molecule comprises at least one of: from         about 10% to about 90% modification, from about 20% to about 90%         modification, from about 30% to about 90% modification, from         about 40% to about 90% modification, from about 50% to about 90%         modification, from about 60% to about 90% modification, from         about 70% to about 90% modification, and from about 80% to about         100% modification. In some embodiments, the polynucleic acid         molecule comprises at least one of: from about 10% to about 80%         modification, from about 20% to about 80% modification, from         about 30% to about 80% modification, from about 40% to about 80%         modification, from about 50% to about 80% modification, from         about 60% to about 80% modification, and from about 70% to about         80% modification. In some embodiments, the polynucleic acid         molecule comprises at least one of: from about 10% to about 70%         modification, from about 20% to about 70% modification, from         about 30% to about 70% modification, from about 40% to about 70%         modification, from about 50% to about 70% modification, and from         about 60% to about 70% modification. In some embodiments, the         polynucleic acid molecule comprises at least one of: from about         10% to about 60% modification, from about 20% to about 60%         modification, from about 30% to about 60% modification, from         about 40% to about 60% modification, and from about 50% to about         60% modification. In some embodiments, the polynucleic acid         molecule comprises at least one of: from about 10% to about 50%         modification, from about 20% to about 50% modification, from         about 30% to about 50% modification, and from about 40% to about         50% modification. In some embodiments, the polynucleic acid         molecule comprises at least one of: from about 10% to about 40%         modification, from about 20% to about 40% modification, and from         about 30% to about 40% modification. In some embodiments, the         polynucleic acid molecule comprises at least one of: from about         10% to about 30% modification, and from about 20% to about 30%         modification. In some embodiments, the polynucleic acid molecule         comprises from about 10% to about 20% modification. In some         embodiments, the polynucleic acid molecule comprises from about         15% to about 90%, from about 20% to about 80%, from about 30% to         about 70%, or from about 40% to about 60% modifications. In some         embodiments, the polynucleic acid molecule comprises at least         about 15%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 95%, or 99%         modification. In some embodiments, the polynucleic acid molecule         comprises at least about 3, about 4, about 5, about 6, about 7,         about 8, about 9, about 10, about 11, about 12, about 13, about         14, about 15, about 16, about 17, about 18, about 19, about 20,         about 21, about 22 or more modifications. In some embodiments,         the polynucleic acid molecule comprises at least about 1, about         2, about 3, about 4, about 5, about 6, about 7, about 8, about         9, about 10, about 11, about 12, about 13, about 14, about 15,         about 16, about 17, about 18, about 19, about 20, about 21,         about 22 or more modified nucleotides. In some embodiments, the         polynucleic acid molecule comprises a single strand. In some         embodiments, the polynucleic acid molecule comprises two or more         strands. In some embodiments, the polynucleic acid molecule         comprises a first polynucleotide and a second polynucleotide         hybridized to the first polynucleotide to form a double-stranded         polynucleic acid molecule. In some embodiments, the second         polynucleotide comprises at least one modification. In some         embodiments, the first polynucleotide and the second         polynucleotide are RNA molecules. In some embodiments, the first         polynucleotide and the second polynucleotide are siRNA         molecules. In some embodiments, X and Y are independently a         bond, a degradable linker, a non-degradable linker, a cleavable         linker, or a non-polymeric linker group. In some embodiments, X         is a bond. In some embodiments, X is a C₁-C₆ alkyl group. In         some embodiments, Y is a C₁-C₆ alkyl group. In some embodiments,         X is a homobifunctional linker or a heterobifunctional linker,         optionally conjugated to a C₁-C₆ alkyl group. In some         embodiments, Y is a homobifunctional linker or a         heterobifunctional linker. In some embodiments, the binding         moiety is an antibody or binding fragment thereof. In some         embodiments, the antibody or binding fragment thereof comprises         a humanized antibody or binding fragment thereof, chimeric         antibody or binding fragment thereof, monoclonal antibody or         binding fragment thereof, monovalent Fab′, divalent Fab2,         single-chain variable fragment (scFv), diabody, minibody,         nanobody, single-domain antibody (sdAb), or camelid antibody or         binding fragment thereof. In some embodiments, C is polyethylene         glycol. In some embodiments, C has a molecular weight of about         5000 Da. In some embodiments, A-X is conjugated to the 5′ end of         B and Y-C is conjugated to the 3′ end of B. In some embodiments,         Y-C is conjugated to the 5′ end of B and A-X is conjugated to         the 3′ end of B. In some embodiments, A-X, Y-C or a combination         thereof is conjugated to an internucleotide linkage group. In         some embodiments, methods further comprise D. In some         embodiments, D is conjugated to C or to A. In some embodiments,         D is conjugated to the molecule conjugate of Formula (II)         according to Formula (IV):         (A-X-B-Y-C_(c))-L-D   Formula IV     -   wherein,     -   A comprises a binding moiety;     -   B consists of a polynucleotide;     -   C consists of a polymer;     -   X consists of a bond or first linker;     -   Y consists of a bond or second linker;     -   L consists of a bond or third linker;     -   D consists of an endosomolytic moiety; and     -   c is an integer between 0 and 1; and     -   wherein the polynucleotide comprises at least one 2′ modified         nucleotide, at least one modified internucleotide linkage, or an         inverted abasic moiety; and D is conjugated anywhere on A, B, or         C.         In some embodiments, D is INF7 or melittin. In some embodiments,         L is a C₁-C₆ alkyl group. In some embodiments, L is a         homobifunctional linker or a heterobifunctional linker. In some         embodiments, methods further comprise at least a second binding         moiety A. In some embodiments, the at least second binding         moiety A is conjugated to A, to B, or to C.

Disclosed herein, in some embodiments, are methods of inducing an insertion, deletion, duplication, or alteration in the incorrectly spliced mRNA transcript to induce exon skipping or exon inclusion in the incorrectly spliced mRNA transcript, the method comprising: contacting a target cell with a polynucleic acid molecule conjugate, wherein the polynucleotide comprises at least one 2′ modified nucleotide, at least one modified internucleotide linkage, or at least one inverted abasic moiety; hybridizing the polynucleic acid molecule conjugate to the incorrectly spliced mRNA transcript within the target cell to induce an insertion, deletion, duplication, or alteration in the incorrectly spliced mRNA transcript to induce exon skipping or exon inclusion, wherein the incorrectly spliced mRNA transcript is capable of encoding a functional form of a protein; and translating the functional form of a protein from a fully processed mRNA transcript of the previous step. In some embodiments, the target cell is a target cell of a subject. In some embodiments, the incorrectly spliced mRNA transcript further induces a disease or disorder. In some embodiments, the disease or disorder is further characterized by one or more mutations in the mRNA. In some embodiments, the disease or disorder comprises a neuromuscular disease, a genetic disease, cancer, a hereditary disease, or a cardiovascular disease. In some embodiments, the disease or disorder is muscular dystrophy. In some embodiments, the disease or disorder is Duchenne muscular dystrophy. In some embodiments, the exon skipping is of exon 8, 23, 35, 43, 44, 45, 50, 51, 52, 53, or 55 of the DMD gene. In some embodiments, the exon skipping is of exon 23 of the DMD gene. In some embodiments, the polynucleic acid molecule conjugate comprises a structure of Formula (I): A-X-B   Formula I

-   -   wherein,     -   A comprises a binding moiety;     -   B consists of a polynucleotide; and     -   X consists of a bond or first linker.         In some embodiments, the polynucleic acid molecule conjugate         comprises a structure of Formula (II):         A-X-B-Y-C   Formula II     -   wherein,     -   A comprises a binding moiety;     -   B consists of a polynucleotide;     -   C consists of a polymer;     -   X consists of a bond or first linker; and     -   Y consists of a bond or second linker.         In some embodiments, the polynucleic acid molecule conjugate         comprises a structure of Formula (III):         A-X-C-Y-B   Formula III     -   wherein,     -   A comprises a binding moiety;     -   B consists of a polynucleotide;     -   C consists of a polymer;     -   X consists of a bond or first linker; and     -   Y consists of a bond or second linker.         In some embodiments, the at least one 2′ modified nucleotide         comprises a morpholino, 2′-O-methyl, 2′-O-methoxyethyl         (2′-O-MOE), 2′-O-aminopropyl, 2′-deoxy, T-deoxy-2′-fluoro,         2′-O-aminopropyl (2′-O-AP), 2′-O-dimethylaminoethyl         (2′-O-DMAOE), 2′-O-dimethylaminopropyl (2′-O-DMAP),         T-O-dimethylaminoethyloxyethyl (2′-O-DMAEOE), or         2′-O—N-methylacetamido (2′-O-NMA) modified nucleotide. In some         embodiments, the at least one 2′ modified nucleotide comprises         locked nucleic acid (LNA), ethylene nucleic acid (ENA), peptide         nucleic acid (PNA). In some embodiments, the at least one 2′         modified nucleotide comprises a morpholino. In some embodiments,         the at least one inverted basic moiety is at least one terminus.         In some embodiments, the at least one modified internucleotide         linkage comprises a phosphorothioate linkage or a         phosphorodithioate linkage. In some embodiments, the polynucleic         acid molecule is at least from about 10 to about 30 nucleotides         in length. In some embodiments, the polynucleic acid molecule is         at least one of: from about 15 to about 30, from about 18 to         about 25, from about 18 to about 24, from about 19 to about 23,         or from about 20 to about 22 nucleotides in length. In some         embodiments, the polynucleic acid molecule is at least about 16,         17, 18, 19, 20, 21, 22, 23, 24, or 25 nucleotides in length. In         some embodiments, the polynucleic acid molecule comprises at         least one of: from about 5% to about 100% modification, from         about 10% to about 100% modification, from about 20% to about         100% modification, from about 30% to about 100% modification,         from about 40% to about 100% modification, from about 50% to         about 100% modification, from about 60% to about 100%         modification, from about 70% to about 100% modification, from         about 80% to about 100% modification, and from about 90% to         about 100% modification. In some embodiments, the polynucleic         acid molecule comprises at least one of: from about 10% to about         90% modification, from about 20% to about 90% modification, from         about 30% to about 90% modification, from about 40% to about 90%         modification, from about 50% to about 90% modification, from         about 60% to about 90% modification, from about 70% to about 90%         modification, and from about 80% to about 100% modification. In         some embodiments, the polynucleic acid molecule comprises at         least one of: from about 10% to about 80% modification, from         about 20% to about 80% modification, from about 30% to about 80%         modification, from about 40% to about 80% modification, from         about 50% to about 80% modification, from about 60% to about 80%         modification, and from about 70% to about 80% modification. In         some embodiments, the polynucleic acid molecule comprises at         least one of: from about 10% to about 70% modification, from         about 20% to about 70% modification, from about 30% to about 70%         modification, from about 40% to about 70% modification, from         about 50% to about 70% modification, and from about 60% to about         70% modification. In some embodiments, the polynucleic acid         molecule comprises at least one of: from about 10% to about 60%         modification, from about 20% to about 60% modification, from         about 30% to about 60% modification, from about 40% to about 60%         modification, and from about 50% to about 60% modification. In         some embodiments, the polynucleic acid molecule comprises at         least one of: from about 10% to about 50% modification, from         about 20% to about 50% modification, from about 30% to about 50%         modification, and from about 40% to about 50% modification. In         some embodiments, the polynucleic acid molecule comprises at         least one of: from about 10% to about 40% modification, from         about 20% to about 40% modification, and from about 30% to about         40% modification. In some embodiments, the polynucleic acid         molecule comprises at least one of: from about 10% to about 30%         modification, and from about 20% to about 30% modification. In         some embodiments, the polynucleic acid molecule comprises from         about 10% to about 20% modification. In some embodiments, the         polynucleic acid molecule comprises from about 15% to about 90%,         from about 20% to about 80%, from about 30% to about 70%, or         from about 40% to about 60% modifications. In some embodiments,         the polynucleic acid molecule comprises at least about 15%, 20%,         30%, 40%, 50%, 60%, 70%, 80%, 90%, 95%, or 99% modification. In         some embodiments, the polynucleic acid molecule comprises at         least about 3, about 4, about 5, about 6, about 7, about 8,         about 9, about 10, about 11, about 12, about 13, about 14, about         15, about 16, about 17, about 18, about 19, about 20, about 21,         about 22 or more modifications. In some embodiments, the         polynucleic acid molecule comprises at least about 1, about 2,         about 3, about 4, about 5, about 6, about 7, about 8, about 9,         about 10, about 11, about 12, about 13, about 14, about 15,         about 16, about 17, about 18, about 19, about 20, about 21,         about 22 or more modified nucleotides. In some embodiments, the         polynucleic acid molecule comprises a single strand. In some         embodiments, the polynucleic acid molecule comprises two or more         strands. In some embodiments, the polynucleic acid molecule         comprises a first polynucleotide and a second polynucleotide         hybridized to the first polynucleotide to form a double-stranded         polynucleic acid molecule. In some embodiments, the second         polynucleotide comprises at least one modification. In some         embodiments, the first polynucleotide and the second         polynucleotide are RNA molecules. In some embodiments, the first         polynucleotide and the second polynucleotide are siRNA         molecules. In some embodiments, X and Y are independently a         bond, a degradable linker, a non-degradable linker, a cleavable         linker, or a non-polymeric linker group. In some embodiments, X         is a bond. In some embodiments, X is a C₁-C₆ alkyl group. In         some embodiments, Y is a C₁-C₆ alkyl group. In some embodiments,         X is a homobifunctional linker or a heterobifunctional linker,         optionally conjugated to a C₁-C₆ alkyl group. In some         embodiments, Y is a homobifunctional linker or a         heterobifunctional linker. In some embodiments, the binding         moiety is an antibody or binding fragment thereof. In some         embodiments, the antibody or binding fragment thereof comprises         a humanized antibody or binding fragment thereof, chimeric         antibody or binding fragment thereof, monoclonal antibody or         binding fragment thereof, monovalent Fab′, divalent Fab2,         single-chain variable fragment (scFv), diabody, minibody,         nanobody, single-domain antibody (sdAb), or camelid antibody or         binding fragment thereof. In some embodiments, C is polyethylene         glycol. In some embodiments, C has a molecular weight of about         5000 Da. In some embodiments, A-X is conjugated to the 5′ end of         B and Y-C is conjugated to the 3′ end of B. In some embodiments,         Y-C is conjugated to the 5′ end of B and A-X is conjugated to         the 3′ end of B. In some embodiments, A-X, Y-C or a combination         thereof is conjugated to an internucleotide linkage group. In         some embodiments, methods further comprise D. In some         embodiments, D is conjugated to C or to A. In some embodiments,         D is conjugated to the molecule conjugate of Formula (II)         according to Formula (IV):         (A-X-B-Y-C_(c))-L-D   Formula IV     -   wherein,     -   A comprises a binding moiety;     -   B consists of a polynucleotide;     -   C consists of a polymer;     -   X consists of a bond or first linker;     -   Y is a bond or second linker;     -   L consists of a bond or third linker;     -   D consists of an endosomolytic moiety; and     -   c is an integer between 0 and 1; and     -   wherein the polynucleotide comprises at least one 2′ modified         nucleotide, at least one modified internucleotide linkage, or an         inverted abasic moiety; and D is conjugated anywhere on A, B, or         C.         In some embodiments, D is INF7 or melittin. In some embodiments,         L is a C₁-C₆ alkyl group. In some embodiments, L is a         homobifunctional linker or a heterobifunctional linker. In some         embodiments, methods further comprise at least a second binding         moiety A. In some embodiments, the at least second binding         moiety A is conjugated to A, to B, or to C. In some embodiments,         the method is an in vivo method. In some embodiments, the method         is an in vitro method. In some embodiments, the subject is a         human.

Disclosed herein, in certain embodiments, are pharmaceutical compositions comprising: a molecule obtained by any one of the methods disclosed herein and a pharmaceutically acceptable excipient. In some embodiments, the pharmaceutical composition is formulated as a nanoparticle formulation. In some embodiments, the pharmaceutical composition is formulated for parenteral, oral, intranasal, buccal, rectal, or transdermal administration.

Disclosed herein, in certain embodiments, are kits comprising a molecule obtained by any one of the methods disclosed herein.

Disclosed herein, in certain embodiments, are compositions comprising a polynucleic acid molecule conjugate, wherein the polynucleic acid molecule conjugate comprises a polynucleotide comprising a sequence having at least 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99%, or 100% sequence identity to SEQ ID NOs: 54-972. Disclosed herein, in certain embodiments, are compositions comprising a polynucleic acid molecule conjugate, wherein the polynucleic acid molecule conjugate comprises a polynucleotide comprising a sequence having at least 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99%, or 100% sequence identity to SEQ ID NOs: 54-972. In certain embodiments, the polynucleic acid molecule conjugate comprises a structure of Formula (I): A-X-B   Formula I

-   -   wherein,     -   A comprises a binding moiety;     -   B consists of the polynucleotide; and     -   X consists of a bond or first linker.         In certain embodiments, the polynucleic acid molecule conjugate         comprises a structure of Formula (II):         A-X-B-Y-C   Formula II     -   wherein,     -   A comprises a binding moiety;     -   B consists of the polynucleotide;     -   C consists of a polymer;     -   X consists of a bond or first linker; and     -   Y consists of a bond or second linker.         In certain embodiments, the polynucleic acid molecule conjugate         comprises a structure of Formula (III):         A-X-C-Y-B   Formula III     -   wherein,     -   A comprises a binding moiety;     -   B consists of the polynucleotide;     -   C consists of a polymer;     -   X consists of a bond or first linker; and     -   Y consists of a bond or second linker.         In certain embodiments, the at least one 2′ modified nucleotide         comprises a morpholino, 2′-O-methyl, 2′-O-methoxyethyl         (2′-O-MOE), 2′-O-aminopropyl, 2′-deoxy, T-deoxy-2′-fluoro,         2′-O-aminopropyl (2′-O-AP), 2′-O-dimethylaminoethyl         (2′-O-DMAOE), 2′-O-dimethylaminopropyl (2′-O-DMAP),         T-O-dimethylaminoethyloxyethyl (2′-O-DMAEOE), or         2′-O—N-methylacetamido (2′-O-NMA) modified nucleotide. In         certain embodiments, the at least one 2′ modified nucleotide         comprises a morpholino.

Disclosed herein, in certain embodiments, are methods of treating a disease or disorder comprising: administering to a subject a polynucleic acid molecule conjugate; wherein the polynucleic acid molecule conjugate comprises a target cell binding moiety and a targeted pre-mRNA specific splice modulating polynucleic acid moiety; wherein the target cell binding moiety specifically binds to a targeted cell, and the targeted pre-mRNA specific splice modulating polynucleic acid moiety induces insertion, deletion, duplication, or alteration of a targeted pre-mRNA transcript in the targeted cell to induce a splicing event in the targeted pre-mRNA transcript to generate a mRNA transcript; and wherein the mRNA transcript encodes a protein that is modified when compared to the same protein in untreated target cells, thereby treating the disease or disorder in the subject. In certain embodiments, the splicing event is exon skipping. In certain embodiments, the splicing event is exon inclusion. In certain embodiments, the disease or disorder is further characterized by one or more mutations in the pre-mRNA. In certain embodiments, the disease or disorder comprises a neuromuscular disease, a genetic disease, cancer, a hereditary disease, or a cardiovascular disease. In certain embodiments, the disease or disorder is muscular dystrophy. In certain embodiments, the disease or disorder is Duchenne muscular dystrophy. In certain embodiments, the splicing event is of exon 8, 23, 35, 43, 44, 45, 50, 51, 52, 53, or 55 of DMD gene. In certain embodiments, the splicing event is of exon 23 of DMD gene. In certain embodiments, the splicing event is of an exon of PAH, MSTN, or K-Ras gene. In certain embodiments, the polynucleic acid molecule conjugate comprises a structure of Formula (I): A-X-B   Formula I

-   -   wherein,     -   A comprises a binding moiety;     -   B consists of a polynucleotide; and     -   X consists of a bond or first linker.         In certain embodiments, the polynucleic acid molecule conjugate         comprises a structure of Formula (II):         A-X-B-Y-C   Formula II     -   wherein,     -   A comprises a binding moiety;     -   B consists of a polynucleotide;     -   C consists of a polymer;     -   X consists a bond or first linker; and     -   Y consists of a bond or second linker.         In certain embodiments, the polynucleic acid molecule conjugate         comprises a structure of Formula (III):         A-X-C-Y-B   Formula III     -   wherein,     -   A comprises a binding moiety;     -   B consists of a polynucleotide;     -   C consists of a polymer;     -   X consists of a bond or first linker; and     -   Y consists of a bond or second linker.         In certain embodiments, the polynucleic acid molecule conjugate         optionally comprises at least one 2′ modified nucleotide, at         least one modified internucleotide linkage, or at least one         inverted abasic moiety. In certain embodiments, the at least one         2′ modified nucleotide comprises a morpholino, 2′-O-methyl,         2′-O-methoxyethyl (2′-O-MOE), 2′-O-aminopropyl, 2′-deoxy,         T-deoxy-2′-fluoro, 2′-O-aminopropyl (2′-O-AP),         2′-O-dimethylaminoethyl (2′-O-DMAOE), 2′-O-dimethylaminopropyl         (2′-O-DMAP), T-O-dimethylaminoethyloxyethyl (2′-O-DMAEOE), or         2′-O—N-methylacetamido (2′-O-NMA) modified nucleotide. In         certain embodiments, the at least one 2′ modified nucleotide         comprises locked nucleic acid (LNA), ethylene nucleic acid         (ENA), or a peptide nucleic acid (PNA). In certain embodiments,         the at least one 2′ modified nucleotide comprises a morpholino.         In certain embodiments, the at least one inverted basic moiety         is at least one terminus. In certain embodiments, the at least         one modified internucleotide linkage comprises a         phosphorothioate linkage or a phosphorodithioate linkage. In         certain embodiments, the polynucleic acid molecule comprises at         least from about 10 to about 30 nucleotides in length. In         certain embodiments, the polynucleic acid molecule comprises at         least about 15%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 95%, or         99% modification. In certain embodiments, the polynucleic acid         molecule comprises a single strand. In certain embodiments, the         polynucleic acid molecule comprises two or more strands. In         certain embodiments, the polynucleic acid molecule comprises a         first polynucleotide and a second polynucleotide hybridized to         the first polynucleotide to form a double-stranded polynucleic         acid molecule. In certain embodiments, the second polynucleotide         comprises at least one modification. In certain embodiments, the         first polynucleotide and the second polynucleotide comprise RNA         molecules. In certain embodiments, the first polynucleotide and         the second polynucleotide comprise siRNA molecules. In certain         embodiments, X is a bond. In certain embodiments, X and Y are         independently a bond, a degradable linker, a non-degradable         linker, a cleavable linker, or a non-polymeric linker group. In         certain embodiments, X and Y are independently a bond, a         degradable linker, a non-degradable linker, a cleavable linker,         or a non-polymeric linker group. In certain embodiments, X is a         C₁-C₆ alkyl group. In certain embodiments, X or Y is a C₁-C₆         alkyl group. In certain embodiments, X or Y is a C₁-C₆ alkyl         group. In certain embodiments, the binding moiety is an antibody         or binding fragment thereof. In certain embodiments, the binding         moiety is an antibody or binding fragment thereof. In certain         embodiments, the binding moiety is an antibody or binding         fragment thereof. In certain embodiments, C is polyethylene         glycol. In certain embodiments, C is polyethylene glycol. In         certain embodiments, A-X is conjugated to the 5′ end of B and         Y-C is conjugated to the 3′ end of B. In certain embodiments,         Y-C is conjugated to the 5′ end of B and A-X is conjugated to         the 3′ end of B. In certain embodiments, methods further         comprise D. In certain embodiments, D is conjugated to C or         to A. In certain embodiments, methods further comprise at least         a second binding moiety A. In certain embodiments, methods         further comprise at least a second binding moiety A. In certain         embodiments, methods further comprise at least a second binding         moiety A.

Disclosed herein, in certain embodiments, are methods of inducing a splicing event in a targeted pre-mRNA transcript, comprising: (a) contacting a target cell with a polynucleic acid molecule conjugate, wherein the polynucleic acid molecule conjugate comprises a target cell binding moiety and a targeted pre-mRNA splice modulating polynucleic acid moiety; (b) hybridizing the targeted pre-mRNA splice modulating polynucleic acid moiety to the targeted pre-mRNA transcript within the target cell to induce the splicing event in the targeted pre-mRNA transcript to produce a mRNA transcript; and (c) optionally, translating the mRNA transcript of step (b) in the target cell to produce a protein. In certain embodiments, the splicing event is exon skipping. In certain embodiments, the splicing event is exon inclusion. In certain embodiments, the targeted pre-mRNA transcript induces a disease or disorder. In certain embodiments, the disease or disorder comprises a neuromuscular disease, a genetic disease, cancer, a hereditary disease, or a cardiovascular disease. In certain embodiments, the polynucleic acid molecule conjugate:

a) comprises a structure of Formula (I): A-X-B   Formula I

-   -   wherein,     -   A comprises a binding moiety;     -   B consists of the polynucleotide; and     -   X consists of a bond or first linker;

b) comprises a structure of Formula (II): A-X-B-Y-C   Formula II

-   -   wherein,     -   A comprises a binding moiety;     -   B consists of the polynucleotide;     -   C consists of a polymer;     -   X consists of a bond or first linker; and     -   Y consists of a bond or second linker; or

c) comprises a structure of Formula (III): A-X-C-Y-B   Formula III

-   -   wherein,     -   A comprises a binding moiety;     -   B consists of the polynucleotide;     -   C consists of a polymer;     -   X consists of a bond or first linker; and     -   Y consists of a bond or second linker.         In certain embodiments, the polynucleic acid molecule conjugate         optionally comprises at least one 2′ modified nucleotide, at         least one modified internucleotide linkage, or at least one         inverted abasic moiety. In certain embodiments, the at least one         2′ modified nucleotide comprises a morpholino, 2′-O-methyl,         2′-O-methoxyethyl (2′-O-MOE), 2′-O-aminopropyl, 2′-deoxy,         T-deoxy-2′-fluoro, 2′-O-aminopropyl (2′-O-AP),         2′-O-dimethylaminoethyl (2′-O-DMAOE), 2′-O-dimethylaminopropyl         (2′-O-DMAP), T-O-dimethylaminoethyloxyethyl (2′-O-DMAEOE), or         2′-O—N-methylacetamido (2′-O-NMA) modified nucleotide. In         certain embodiments, the at least one 2′ modified nucleotide         comprises locked nucleic acid (LNA), ethylene nucleic acid         (ENA), peptide nucleic acid (PNA). In certain embodiments, the         at least one 2′ modified nucleotide comprises a morpholino. In         certain embodiments, the at least one inverted basic moiety is         at least one terminus. In certain embodiments, the at least one         modified internucleotide linkage comprises a phosphorothioate         linkage or a phosphorodithioate linkage. In certain embodiments,         the polynucleic acid molecule comprises at least from about 10         to about 30 nucleotides in length. In certain embodiments, the         polynucleic acid molecule comprises at least about 15%, 20%,         30%, 40%, 50%, 60%, 70%, 80%, 90%, 95%, or 99% modification. In         certain embodiments, the polynucleic acid molecule comprises at         least about 3, about 4, about 5, about 6, about 7, about 8,         about 9, about 10, about 11, about 12, about 13, about 14, about         15, about 16, about 17, about 18, about 19, about 20, about 21,         about 22 or more modifications. In certain embodiments, X and Y         are independently a bond, a degradable linker, a non-degradable         linker, a cleavable linker, or a non-polymeric linker group. In         certain embodiments, X is a bond. In certain embodiments, X is a         C₁-C₆ alkyl group. In certain embodiments, Y is a C₁-C₆ alkyl         group. In certain embodiments, X is a homobifunctional linker or         a heterobifunctional linker, optionally conjugated to a C₁-C₆         alkyl group. In certain embodiments, Y is a homobifunctional         linker or a heterobifunctional linker. In certain embodiments,         the binding moiety is an antibody or binding fragment thereof.         In certain embodiments, C is polyethylene glycol. In certain         embodiments, A-X is conjugated to the 5′ end of B and Y-C is         conjugated to the 3′ end of B. In certain embodiments, Y-C is         conjugated to the 5′ end of B and A-X is conjugated to the 3′         end of B. In certain embodiments, A-X, Y-C or a combination         thereof is conjugated to an internucleotide linkage group. In         certain embodiments, methods further comprise D. In certain         embodiments, D is conjugated to C or to A. In certain         embodiments, methods further comprise at least a second binding         moiety A.

Disclosed herein, in certain embodiments, are polynucleic acid molecule conjugate compositions comprising a target cell binding moiety and a targeted pre-mRNA specific splice modulating polynucleic acid moiety wherein the targeted pre-mRNA specific splice modulating polynucleic acid moiety comprises a sequence having at least 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99%, or 100% sequence identity to SEQ ID NOs: 54-972. In certain embodiments, the polynucleic acid molecule conjugate:

a) comprises a structure of Formula (I): A-X-B   Formula I

-   -   wherein,     -   A comprises a binding moiety;     -   B consists of the polynucleotide; and     -   X consists of a bond or first linker;

b) comprises a structure of Formula (II): A-X-B-Y-C   Formula II

-   -   wherein,     -   A comprises a binding moiety;     -   B consists of the polynucleotide;     -   C consists of a polymer;     -   X consists of a bond or first linker; and     -   Y consists of a bond or second linker; or

c) comprises a structure of Formula (III): A-X-C-Y-B   Formula III

-   -   wherein,     -   A comprises a binding moiety;     -   B consists of the polynucleotide;     -   C consists of a polymer;     -   X consists of a bond or first linker; and     -   Y consists of a bond or second linker.         In certain embodiments, the pharmaceutical composition is         formulated as a nanoparticle formulation.

DESCRIPTION OF THE DRAWINGS

FIG. 1 depicts a phosphorodiamidate morpholino oligomer (PMO) sequence with end nucleotides expanded (SEQ ID NO: 28).

FIG. 2A depicts a phosphorothioate antisense oligonucleotide (PS ASO) sequence with end nucleotides expanded (SEQ ID NO: 29).

FIG. 2B depicts a fully expanded phosphorothioate antisense oligonucleotide (PS ASO) sequence (SEQ ID NO: 29).

FIG. 3 depicts methods used to quantify skipped DMD mRNA in total RNA using Taqman qPCR.

FIG. 4 depicts a chromatogram of anti-CD71 mAb-PMO reaction mixture produced with hydrophobic interaction chromatography (HIC) method 2.

FIG. 5A depicts a chromatogram of anti-CD71 mAb produced using size exclusion chromatography (SEC) method 1.

FIG. 5B depicts a chromatogram of anti-CD71 mAb-PMO DAR 1,2 produced using size exclusion chromatography (SEC) method 1.

FIG. 5C depicts a chromatogram of anti-CD71 mAb-PMO DAR>2 produced using size exclusion chromatography (SEC) method 1.

FIG. 6A depicts a chromatogram of anti-CD71 mAb produced using hydrophobic interaction chromatography (HIC) method 2.

FIG. 6B depicts a chromatogram of purified anti-CD71 mAb-PMO DAR 1,2 conjugate produced using hydrophobic interaction chromatography (HIC) method 2.

FIG. 6C depicts a chromatogram of purified anti-CD71 mAb-PMO DAR>2 conjugate produced using hydrophobic interaction chromatography (HIC) method 2.

FIG. 7A depicts a chromatogram of fast protein liquid chromatography (FPLC) purification of anti-CD71 Fab-PMO using hydrophobic interaction chromatography (HIC) method 3.

FIG. 7B depicts a chromatogram of anti-CD71 Fab produced using SEC method 1.

FIG. 7C depicts a chromatogram of anti-CD71 Fab-PMO DAR 1 conjugate produced using SEC method 1.

FIG. 7D depicts a chromatogram of anti-CD71 Fab-PMO DAR 2 conjugate produced using SEC method 1.

FIG. 7E depicts a chromatogram of anti-CD71 Fab-PMO DAR 3 conjugate produced using SEC method 1.

FIG. 7F depicts a chromatogram of anti-CD71 Fab produced using HIC method 4.

FIG. 7G depicts a chromatogram of anti-CD71 Fab-PMO DAR 1 conjugate produced using HIC method 4.

FIG. 7H depicts a chromatogram of anti-CD71 Fab-PMO DAR 2 conjugate produced using HIC method 4.

FIG. 7I depicts a chromatogram of anti-CD71 Fab-PMO DAR 3 conjugate produced using HIC method 4.

FIG. 8A depicts a chromatogram of anti-CD71 mAb-PS ASO reaction mixture produced with SAX method 2.

FIG. 8B depicts a chromatogram of anti-CD71 mAb produced using SEC method 1.

FIG. 8C depicts a chromatogram of anti-CD71 mAb-PS ASO DAR 1 conjugate produced using SEC method 1.

FIG. 8D depicts a chromatogram of anti-CD71 mAb-PS ASO DAR 2 conjugate produced using SEC method 1.

FIG. 8E depicts a chromatogram of anti-CD71 mAb-PS ASO DAR 3 conjugate produced using SEC method 1.

FIG. 8F depicts a chromatogram of anti-CD71 mAb-PS ASO DAR 1 conjugate produced using SAX method 2.

FIG. 8G depicts a chromatogram of anti-CD71 mAb-PS ASO DAR 2 conjugate produced using SAX method 2.

FIG. 8H depicts a chromatogram of anti-CD71 mAb-PS ASO DAR 3 conjugate produced using SAX method 2.

FIG. 9 depicts an agarose gel from nested PCR detecting exon 23 skipping in differentiated C2C12 cells using PMO and anti-CD71 mAb-PMO conjugate.

FIG. 10 depicts an agarose gel from nested PCR detecting exon 23 skipping in differentiated C2C12 cells using PMO, anti-CD71 mAb-PMO, and anti-CD71 Fab-PMO conjugates.

FIG. 11 depicts an agarose gel from nested PCR detecting exon 23 skipping in differentiated C2C12 cells PMO, ASO, conjugated anti-CD71 mAb-ASO of DAR1 (“ASC-DAR1”), conjugated anti-CD71 mAb-ASO of DAR2 (“ASC-DAR2”), and conjugated anti-CD71 mAb-ASO of DAR3 (“ASC-DAR3”).

FIG. 12A depicts an agarose gel from nested PCR detecting exon 23 skipping in gastrocnemius muscle of wild-type mice administered a single intravenous injection of anti-CD71 mAb-PMO conjugate.

FIG. 12B is a graph of quantification of PCR products from gastrocnemius muscle.

FIG. 12C is a graph of quantification of in vivo exon skipping using Taqman qPCR from gastrocnemius muscle from wild-type mice.

FIG. 13A depicts an agarose gel from nested PCR detecting exon 23 skipping in heart muscle from wild-type mice after a single intravenous injection.

FIG. 13B is a graph of quantification of PCR products from heart muscle.

FIG. 14 depicts sequencing data of DNA fragments from skipped and wild-type PCR products (SEQ ID NOS 976-977, respectively).

FIG. 15A is a graph of quantification of in vivo exon skipping in wild type mice in gastrocnemius muscle using Taqman qPCR.

FIG. 15B is a graph of quantification of in vivo exon skipping in wild type mice in gastrocnemius muscle using nested PCR.

FIG. 15C is a graph of quantification of in vivo exon skipping in wild type mice in diaphragm muscle using Taqman qPCR.

FIG. 15D is a graph of quantification of in vivo exon skipping in wild type mice in diaphragm muscle using nested PCR.

FIG. 15E is a graph of quantification of in vivo exon skipping in wild type mice in heart muscle using Taqman qPCR.

FIG. 15F is a graph of quantification of in vivo exon skipping in wild type mice in heart muscle using nested PCR.

FIG. 16A depicts an agarose gel from PCR detecting CD71 mAb-PMO conjugate induction of MSTN exon 2 skipping in diaphragm muscle tissues in wild type mice after a single intravenous (i.v.) injection.

FIG. 16B depicts an agarose gel from PCR detecting CD71 mAb-PMO conjugate induction of MSTN exon 2 skipping in heart muscle tissues in wild type mice after a single intravenous (i.v.) injection.

FIG. 16C depicts an agarose gel from PCR detecting CD71 mAb-PMO conjugate induction of MSTN exon 2 skipping in gastrocnemius muscle tissues in wild type mice after a single intravenous (i.v.) injection.

FIG. 17 depicts an agarose gel from PCR detecting ASGPR mAb-PMO conjugate induction of PAH exon 11 skipping in primary mouse hepatocytes.

FIG. 18 depicts an agarose gel from PCR detecting ASGPR mAb-PMO conjugate induction of PAH exon 11 skipping in livers from wild type mice after a single intravenous (i.v.) injection.

FIG. 19A-FIG. 19L illustrate cartoon representations of molecules described herein.

DETAILED DESCRIPTION OF THE DISCLOSURE

Nucleic acid (e.g., RNAi) therapy is a targeted therapy with high selectivity and specificity. However, in some instances, nucleic acid therapy is also hindered by poor intracellular uptake, insufficient intracellular concentrations in target cells, and low efficacy. To address these issues, various modifications of the nucleic acid composition are explored, such as for example, novel linkers for better stabilizing and/or lower toxicity, optimization of binding moiety for increased target specificity and/or target delivery, and nucleic acid polymer modifications for increased stability and/or reduced off-target effect.

In some instances, one such area where oligonucleotide is used is for treating muscular dystrophy. Muscular dystrophy encompasses several diseases that affect the muscle. Duchenne muscular dystrophy is a severe form of muscular dystrophy and caused by mutations in the DMD gene. In some instances, mutations in the DMD gene disrupt the translational reading frame and results in non-functional dystrophin protein.

Described herein, in certain embodiments, are methods and compositions relating nucleic acid therapy to induce an insertion, deletion, duplication, or alteration in an incorrectly spliced mRNA transcript to induce exon skipping or exon inclusion, which is used to restore the translational reading frame. In some embodiments, also described herein include methods and compositions for treating a disease or disorder characterized by an incorrectly processed mRNA transcript, in which after removal of an exon, the mRNA is capable of encoding a functional protein, thereby treating the disease or disorder. In additional embodiments, described herein include pharmaceutical compositions and kits for treating the same.

RNA Processing

RNA has a central role in regulation of gene expression and cell physiology. Proper processing of RNA is important for translational of functional protein. Alterations in RNA processing such as a result of incorrect splicing of RNA can result in disease. For example, mutations in a splice site causes exposure of a premature stop codon, a loss of an exon, or inclusion of an intron. In some instances, alterations in RNA processing results in an insertion, deletion, or duplication. In some instances, alterations in RNA processing results in an insertion, deletion, or duplication of an exon. Alterations in RNA processing, in some cases, results in an insertion, deletion, or duplication of an intron.

Alternative transcriptional or splicing events include, but are not limited to, exon skipping, alternative 3′ splice site selection, alternative 5′ splice site selection, intron retention, mutually exclusive exons, alternative promoter usage, and alternative polyadenylation. Splicing events, in some embodiments, results in an insertion, deletion, or duplication of an exon, for example, by exon skipping or exon inclusion.

Exon Skipping

Exon skipping is a form of RNA splicing. In some cases, exon skipping occurs when an exon is skipped over or is spliced out of the processed mRNA. As a result of exon skipping, the processed mRNA does not contain the skipped exon. In some instances, exon skipping results in expression of an altered product.

In some instances, antisense oligonucleotides (AONs) are used to induce exon skipping. In some instances, AONs are short nucleic acid sequences that bind to specific mRNA or pre-mRNA sequences. For example, AONs bind splice sites or exonic enhancers. In some instances, binding of AONs to specific mRNA or pre-mRNA sequences generates double-stranded regions. In some instances, formation of double-stranded regions occurs at sites where the spliceosome or proteins associated with the spliceosome would normally bind and causes exons to be skipped. In some instances, skipping of exons results in restoration of the transcript reading frame and allows for production of a partially functional protein.

Exon Inclusion

In some instances, a mutation in RNA results in exon skipping. In some cases, a mutation is at least one of at the splice site, near the splice site, and at a distance from the splice site. In some instances, the mutations result in at least one of inactivating or weakening the splice site, disrupting exon splice enhancer or intron splice enhancer, and creating an exon splice silencer or intron splice enhancer. Mutations in some instances alter RNA secondary structure. In some cases, a mutation alters a RNA secondary structure result in disrupting the accessibility of signals important for exon recognition.

In some instances, use of AONs results in inclusion of the skipped exon. In some instances, the AONs bind to at least one of a splice site, a site near a splice site, and a site distant to a splice site. In some cases, AONs bind at site in the RNA to prevent disruption of an exon splice enhancer or intron splice enhancer. In some instances, AONs bind at site in the RNA to prevent creation of an exon splice silencer or intron splice silencer.

Intron Retention

In some instances, a mutation in RNA results in intron retention. Intron retention results in an intron remaining in the mature mRNA transcript. In some instances, presence of a retained intron prevents or reduces translation of a functional protein. In some instances, intron retention occurs in a coding region, a non-coding region, at the 5′ UTR, or at the 3′ UTR. Where intron retention occurs in a coding region, in some instances, the retained intron encodes amino acids in frame, or is in misalignment which generates truncated proteins or non-functional proteins due to stop codon or frame shifts. In some instances, the intron is retained between two exons, located at the 5′ UTR, or located at the 3′ UTR.

In some instances, AONs are used to hybridize to a partially processed mRNA to initiate removal of a retained intron. In some instances, the AONs hybridize to an intronic splicing enhancer or an intronic splicing silencer. In some instances, the AONs hybridize at or a distance from a 5′ splice site, 3′ splice site, branchpoint, polypyrimidine tract, an intron silencer site, a cryptic intron splice site, a pseudo splice site, or an intron enhancer of the intron. In some instances, the AONs hybridize to an internal region of the intron.

Indications

In some embodiments, a polynucleic acid molecule or a pharmaceutical composition described herein is used for the treatment of a disease or disorder characterized with a defective mRNA. In some embodiments, a polynucleic acid molecule or a pharmaceutical composition described herein is used for the treatment of disease or disorder by inducing an insertion, deletion, duplication, or alteration in an incorrectly spliced mRNA transcript to induce a splicing event. In some embodiments, the splicing event is exon skipping or exon inclusion. In some embodiments, the splicing event is intron retention.

In some embodiments, a polynucleic acid molecule or a pharmaceutical composition described herein is used for the treatment of disease or disorder by inducing an insertion, deletion, duplication, or alteration in an incorrectly spliced mRNA transcript to induce exon skipping or exon inclusion.

A large percentage of human protein-coding genes are alternatively spliced. In some instances, a mutation results in improperly spliced or partially spliced mRNA. For example, a mutation is in at least one of a splice site in a protein coding gene, a silencer or enhancer sequence, exonic sequences, or intronic sequences. In some instances, a mutation results in gene dysfunction. In some instances, a mutation results in a disease or disorder.

In some instances, a disease or disorder resulting from improperly spliced or partially spliced mRNA includes, but not limited to, a neuromuscular disease, a genetic disease, cancer, a hereditary disease, or a cardiovascular disease.

In some instances, genetic diseases or disorders include an autosomal dominant disorder, an autosomal recessive disorder, X-linked dominant disorder, X-linked recessive disorder, Y-linked disorder, mitochondrial disease, or multifactorial or polygenic disorder.

In some instances, cardiovascular disease such as hypercholesterolemia results from improperly spliced or partially spliced mRNA. In hypercholesterolemia, it has been shown that a single nucleotide polymorphism in exon 12 of the low density lipoprotein receptor (LDLR) promotes exon skipping.

In some instances, improperly spliced or partially spliced mRNA results in cancer. For example, improperly spliced or partially spliced mRNA affects cellular processes involved in cancer including, but not limited to, proliferation, motility, and drug response. In some instances is a solid cancer or a hematologic cancer. In some instances, the cancer is bladder cancer, lung cancer, brain cancer, melanoma, breast cancer, Non-Hodgkin lymphoma, cervical cancer, ovarian cancer, colorectal cancer, pancreatic cancer, esophageal cancer, prostate cancer, kidney cancer, skin cancer, leukemia, thyroid cancer, liver cancer, or uterine cancer.

Improperly spliced or partially spliced mRNA in some instances causes a neuromuscular disease or disorder. Exemplary neuromuscular diseases include muscular dystrophy such as Duchenne muscular dystrophy, Becker muscular dystrophy, facioscapulohumeral muscular dystrophy, congenital muscular dystrophy, or myotonic dystrophy. In some instances, muscular dystrophy is genetic. In some instances, muscular dystrophy is caused by a spontaneous mutation. Becker muscular dystrophy and Duchenne muscular dystrophy have been shown to involve mutations in the DMD gene, which encodes the protein dystrophin. Facioscapulohumeral muscular dystrophy has been shown to involve mutations in double homeobox, 4 (DUX4) gene.

In some instances, improperly spliced or partially spliced mRNA causes Duchenne muscular dystrophy. Duchenne muscular dystrophy results in severe muscle weakness and is caused by mutations in the DMD gene that abolishes the production of functional dystrophin. In some instances, Duchenne muscular dystrophy is a result of a mutation in an exon in the DMD gene. In some instances, Duchenne muscular dystrophy is a result of a mutation in at least one of exon 1, 2, 3, 4, 5, 6, 7, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78 and 79 in the DMD gene. In some instances, Duchenne muscular dystrophy is a result of a mutation in at least one of exon 3, 4, 5, 6, 7, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, and 63 in the DMD gene. In some instances, Duchenne muscular dystrophy is a result of a mutation in at least one of exon 8, 23, 35, 43, 44, 45, 50, 51, 52, 53, and 55 in the DMD gene. In some instances, multiple exons are mutated. For example, mutation of exons 48-50 is common in Duchenne muscular dystrophy patients. In some instances, Duchenne muscular dystrophy is a result of mutation of exon 51. In some instances, Duchenne muscular dystrophy is a result of mutation of exon 23. In some instances, a mutation involves a deletion of an exon. In some instances, a mutation involves a duplication of an exon. In some instances, a mutation involves a point mutation in an exon. For example, it has been shown that some patients have a nonsense point mutation in exon 51 of the DMD gene.

In some instances, a polynucleic acid molecule or a pharmaceutical composition described herein is used for the treatment of muscular dystrophy. In some instances, a polynucleic acid molecule or a pharmaceutical composition described herein is used for the treatment of Duchenne muscular dystrophy, Becker muscular dystrophy, facioscapulohumeral muscular dystrophy, congenital muscular dystrophy, or myotonic dystrophy. In some instances, a polynucleic acid molecule or a pharmaceutical composition described herein is used for the treatment of Duchenne muscular dystrophy.

Polynucleic Acid Molecule

In some embodiments, a polynucleic acid molecule described herein that induces an insertion, deletion, duplication, or alteration in an incorrectly spliced mRNA transcript to induce exon skipping or exon inclusion. In some instances, the polynucleic acid molecule restores the translational reading frame. In some instances, the polynucleic acid molecule results in a functional and truncated protein.

In some instances, a polynucleic acid molecule targets a mRNA sequence. In some instances, the polynucleic acid molecule targets a splice site. In some instances, the polynucleic acid molecule targets a cis-regulatory element. In some instances, the polynucleic molecule targets a trans-regulatory element. In some instances, the polynucleic acid molecule targets exonic splice enhancers or intronic splice enhancers. In some instances, the polynucleic acid molecule targets exonic splice silencers or intronic splice silencers.

In some instances, a polynucleic acid molecule targets a sequence found in introns or exons. For example, the polynucleic acid molecule targets a sequence found in an exon that mediates splicing of said exon. In some instances, the polynucleic acid molecule targets an exon recognition sequence. In some instances, the polynucleic acid molecule targets a sequence upstream of an exon. In some instances, the polynucleic acid molecule targets a sequence downstream of an exon.

As described above, a polynucleic acid molecule targets an incorrectly processed mRNA transcript which results in a disease or disorder not limited to a neuromuscular disease, a genetic disease, cancer, a hereditary disease, or a cardiovascular disease.

In some instances, a polynucleic acid molecule targets an exon that is mutated in a gene that causes a disease or disorder. Exemplary diseases or disorders include, but are not limited to, familial dysautonomia (FD), spinal muscular atrophy (SMA), medium-chain acyl-CoA dehydrogenase (MCAD) deficiency, Hutchinson-Gilford progeria syndrome (HGPS), myotonic dystrophy type I (DM1), myotonic dystrophy type II (DM2), autosomal dominant retinitis pigmentosa (RP), Duchenne muscular dystrophy (DMD), microcephalic steodysplastic primordial dwarfism type 1 (MOPD1) (Taybi-Linder syndrome (TALS)), frontotemporal dementia with parkinsonism-17 (FTDP-17), Fukuyama congenital muscular dystrophy (FCMD), amyotrophic lateral sclerosis (ALS), hypercholesterolemia, and cystic fibrosis (CF). Exemplary genes that are involved in the disease or disorder include, but are not limited to, IKBKAP, SMN2, MCAD, LMNA, DMPK, ZNF9, MAPT, FKTN, TDP-43, LDLR, CFTR, DMD, PAH, MSTN, and K-Ras. In some embodiments, the gene is DMD, PAH, MSTN, or K-Ras.

In some instances, a polynucleic acid molecule described herein targets a region that is at the exon-intron junction of an exon of a gene that causes a disease or disorder. In some embodiments, the gene is IKBKAP, SMN2, MCAD, LMNA, DMPK, ZNF9, MAPT, FKTN, TDP-43, LDLR, CFTR, DMD, PAH, MSTN, or K-Ras. In some embodiments, a polynucleic acid molecule described herein targets a region that is at the exon-intron junction of exon 1, 2, or 3 of MSTN. In some embodiments, a polynucleic acid molecule described herein targets a region that is at the exon-intron junction of exon 2 of MSTN. In some embodiments, a polynucleic acid molecule described herein targets a region that is at the exon-intron junction of exon 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, or 21 of PAH. In some embodiments, a polynucleic acid molecule described herein targets a region that is at the exon-intron junction of exon 11 of PAH.

In some instances, the polynucleic acid molecule hybridizes to a target region that is at either the 5′ intron-exon junction or the 3′ exon-intron junction of at least one of an exon of a gene that causes a disease or disorder. In some embodiments, the gene is IKBKAP, SMN2, MCAD, LMNA, DMPK, ZNF9, MAPT, FKTN, TDP-43, LDLR, CFTR, DMD, PAH, MSTN, or K-Ras. In some embodiments, a polynucleic acid molecule described herein targets either the 5′ intron-exon junction or the 3′ exon-intron junction of exon 1, 2, or 3 of MSTN. In some embodiments, a polynucleic acid molecule described herein targets a region that is either the 5′ intron-exon junction or the 3′ exon-intron junction of exon 2 of MSTN. In some embodiments, a polynucleic acid molecule described herein targets a region that is either the 5′ intron-exon junction or the 3′ exon-intron junction of exon 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, or 21 of PAH. In some embodiments, a polynucleic acid molecule described herein targets a region that is either the 5′ intron-exon junction or the 3′ exon-intron junction of exon 11 of PAH.

In some cases, the polynucleic acid molecule hybridizes to a target region that is at the 5′ intron-exon junction of at least one of exon of a gene that causes a disease or disorder. In some embodiments, the gene is IKBKAP, SMN2, MCAD, LMNA, DMPK, ZNF9, MAPT, FKTN, TDP-43, LDLR, CFTR, DMD, PAH, MSTN, or K-Ras. In some embodiments, a polynucleic acid molecule described herein targets a region that is at the 5′ intron-exon junction of exon 1, 2, or 3 of MSTN. In some embodiments, a polynucleic acid molecule described herein targets a region that is at the 5′ intron-exon junction of exon 2 of MSTN. In some embodiments, a polynucleic acid molecule described herein targets a region that is at the 5′ intron-exon junction of exon 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, or 21 of PAH. In some embodiments, a polynucleic acid molecule described herein targets a region that is at the 5′ intron-exon junction of exon 11 of PAH.

In some cases, the polynucleic acid molecule hybridizes to a target region that is at the 3′ exon-intron junction of at least one of exon of a gene that causes a disease or disorder. In some embodiments, the gene is IKBKAP, SMN2, MCAD, LMNA, DMPK, ZNF9, MAPT, FKTN, TDP-43, LDLR, CFTR, DMD, PAH, MSTN, or K-Ras. In some embodiments, a polynucleic acid molecule described herein targets a region that is at the 3′ exon-intron junction of exon 1, 2, or 3 of MSTN. In some embodiments, a polynucleic acid molecule described herein targets a region that is at the 3′ exon-intron junction of exon 2 of MSTN. In some embodiments, a polynucleic acid molecule described herein targets a region that is at the 3′ exon-intron junction of exon 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, or 21 of PAH. In some embodiments, a polynucleic acid molecule described herein targets a region that is at the 3′ exon-intron junction of exon 11 of PAH.

In some cases, the polynucleic acid molecule described herein targets a splice site of an exon of a gene that causes a disease or disorder. In some embodiments, the gene is IKBKAP, SMN2, MCAD, LMNA, DMPK, ZNF9, MAPT, FKTN, TDP-43, LDLR, CFTR, DMD, PAH, MSTN, or K-Ras. In some embodiments, a polynucleic acid molecule described herein targets a splice site of exon 1, 2, or 3 of MSTN. In some embodiments, a polynucleic acid molecule described herein targets a splice site of exon 2 of MSTN. In some embodiments, a polynucleic acid molecule described herein targets a splice site of exon 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, or 21 of PAH. In some embodiments, a polynucleic acid molecule described herein targets a splice site of exon 11 of PAH. As used herein, a splice site includes a canonical splice site, a cryptic splice site or an alternative splice site that is capable of inducing an insertion, deletion, duplication, or alteration in an incorrectly spliced mRNA transcript to induce exon skipping or exon inclusion.

In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nucleotides (nt), 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt upstream (or from the 5′) of an exon of a gene that causes a disease or disorder. In some embodiments, the gene is IKBKAP, SMN2, MCAD, LMNA, DMPK, ZNF9, MAPT, FKTN, TDP-43, LDLR, CFTR, DMD, PAH, MSTN, or K-Ras. In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nt, 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt upstream (or from the 5′) of exon 1, 2, or 3 of the MSTN gene. In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nt, 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt upstream (or from the 5′) of exon 2 of the MSTN gene. In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nt, 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt upstream (or from the 5′) of exon 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, or 21 of PAH gene. In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nt, 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt upstream (or from the 5′) of exon 11 of the PAH gene.

In some instances, the polynucleic acid molecule hybridizes to a target region that is upstream (or 5′) to at least one of an exon of a gene that causes a disease or disorder. In some embodiments, the gene is IKBKAP, SMN2, MCAD, LMNA, DMPK, ZNF9, MAPT, FKTN, TDP-43, LDLR, CFTR, DMD, PAH, MSTN, or K-Ras. In some instances, the polynucleic acid molecule hybridizes to a target region that is upstream (or 5′) to at least one of exon 1, 2, or 3 of the MSTN gene. In some instances, the polynucleic acid molecule hybridizes to a target region that is about 5, 10, 15, 20, 50, 100, 200, 300, 400 or 500 bp upstream (or 5′) to at least one of exon 2 of the MSTN gene. In some instances, the polynucleic acid molecule hybridizes to a target region that is upstream (or 5′) to at least one of exon 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, or 21 of the PAH gene. In some instances, the polynucleic acid molecule hybridizes to a target region that is about 5, 10, 15, 20, 50, 100, 200, 300, 400 or 500 bp upstream (or 5′) to at least one of exon 11 of the PAH gene.

In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nucleotides (nt), 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt downstream (or from the 3′) of an exon of a gene that causes a disease or disorder. In some embodiments, the gene is IKBKAP, SMN2, MCAD, LMNA, DMPK, ZNF9, MAPT, FKTN, TDP-43, LDLR, CFTR, DMD, PAH, MSTN, or K-Ras. In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nucleotides (nt), 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt downstream (or from the 3′) of exon 1, 2, or 3 of the MSTN gene. In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nucleotides (nt), 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt downstream (or from the 3′) of exon 2 of the MSTN gene. In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nucleotides (nt), 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt downstream (or from the 3′) of exon 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, or 21 of the PAH gene. In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nucleotides (nt), 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt downstream (or from the 3′) of exon 11 of the PAH gene.

In some instances, the polynucleic acid molecule hybridizes to a target region that is downstream (or 3′) to at least one of an exon of a gene that causes a disease or disorder. In some embodiments, the gene is IKBKAP, SMN2, MCAD, LMNA, DMPK, ZNF9, MAPT, FKTN, TDP-43, LDLR, CFTR, DMD, PAH, MSTN, or K-Ras. In some instances, the polynucleic acid molecule hybridizes to a target region that is about 5, 10, 15, 20, 50, 100, 200, 300, 400 or 500 bp downstream (or 3′) to at least one of exon 1, 2, or 3 of the MSTN gene. In some instances, the polynucleic acid molecule hybridizes to a target region that is about 5, 10, 15, 20, 50, 100, 200, 300, 400 or 500 bp downstream (or 3′) to at least one of exon 2 of the MSTN gene. In some instances, the polynucleic acid molecule hybridizes to a target region that is about 5, 10, 15, 20, 50, 100, 200, 300, 400 or 500 bp downstream (or 3′) to at least one of exon 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, or 21 of the PAH gene. In some instances, the polynucleic acid molecule hybridizes to a target region that is about 5, 10, 15, 20, 50, 100, 200, 300, 400 or 500 bp downstream (or 3′) to at least one of exon 11 of the PAH gene.

In some instances, a polynucleic acid molecule described herein targets an internal region within an exon of a gene that causes a disease or disorder. In some embodiments, the gene is IKBKAP, SMN2, MCAD, LMNA, DMPK, ZNF9, MAPT, FKTN, TDP-43, LDLR, CFTR, DMD, PAH, MSTN, or K-Ras. In some instances, a polynucleic acid molecule described herein targets an internal region within exon 1, 2, or 3 of the MSTN gene. In some instances, a polynucleic acid molecule described herein targets an internal region within exon 2 of the MSTN gene. In some instances, a polynucleic acid molecule described herein targets an internal region within 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, or 21 of the PAH gene. In some instances, a polynucleic acid molecule described herein targets an internal region within exon 11 of the PAH gene.

In some cases, a polynucleic acid molecule targets an incorrectly processed mRNA transcript which results in a neuromuscular disease or disorder. In some cases, a neuromuscular disease or disorder is Duchenne muscular dystrophy, Becker muscular dystrophy, facioscapulohumeral muscular dystrophy, congenital muscular dystrophy, or myotonic dystrophy. In some cases, a polynucleic acid molecule targets an incorrectly processed mRNA transcript which results in Duchenne muscular dystrophy, Becker muscular dystrophy, facioscapulohumeral muscular dystrophy, congenital muscular dystrophy, or myotonic dystrophy. In some cases, a polynucleic acid molecule targets an incorrectly processed mRNA transcript which results in Duchenne muscular dystrophy.

In some instances, a polynucleic acid molecule targets an exon that is mutated in the DMD gene that causes Duchenne muscular dystrophy. Exemplary exons that are mutated in the DMD gene that causes Duchenne muscular dystrophy include, but not limited to, exon 3, 4, 5, 6, 7, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, and 63. In some instances, the polynucleic acid molecule targets a sequence adjacent to a mutated exon. For example, if there is a deletion of exon 50, the polynucleic acid molecule targets a sequence in exon 51 so that exon 51 is skipped. In another instance, if there is a mutation in exon 23, the polynucleic acid molecule targets a sequence in exon 22 so that exon 23 is skipped.

In some instances, a polynucleic acid molecule described herein targets a region that is at the exon-intron junction of exon 3, 4, 5, 6, 7, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, or 63 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets a region that is at the exon-intron junction of exon 8, 23, 35, 43, 44, 45, 50, 51, 52, 53, or 55 of the DMD gene. In some cases, a polynucleic acid molecule described herein targets a region that is at the exon-intron junction of exon 8 of the DMD gene. In some cases, a polynucleic acid molecule described herein targets a region that is at the exon-intron junction of exon 23 of the DMD gene. In some cases, a polynucleic acid molecule described herein targets a region that is at the exon-intron junction of exon 35 of the DMD gene. In some cases, a polynucleic acid molecule described herein targets a region that is at the exon-intron junction of exon 43 of the DMD gene. In some cases, a polynucleic acid molecule described herein targets a region that is at the exon-intron junction of exon 44 of the DMD gene. In some cases, a polynucleic acid molecule described herein targets a region that is at the exon-intron junction of exon 45 of the DMD gene. In some cases, a polynucleic acid molecule described herein targets a region that is at the exon-intron junction of exon 48 of the DMD gene. In some cases, a polynucleic acid molecule described herein targets a region that is at the exon-intron junction of exon 49 of the DMD gene. In some cases, a polynucleic acid molecule described herein targets a region that is at the exon-intron junction of exon 50 of the DMD gene. In some cases, a polynucleic acid molecule described herein targets a region that is at the exon-intron junction of exon 51 of the DMD gene. In some cases, a polynucleic acid molecule described herein targets a region that is at the exon-intron junction of exon 52 of the DMD gene. In some cases, a polynucleic acid molecule described herein targets a region that is at the exon-intron junction of exon 53 of the DMD gene. In some cases, a polynucleic acid molecule described herein targets a region that is at the exon-intron junction of exon 55 of the DMD gene.

In some instances, the polynucleic acid molecule hybridizes to a target region that is at either the 5′ intron-exon junction or the 3′ exon-intron junction of at least one of exon 3, 4, 5, 6, 7, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, and 63 of the DMD gene. In some instances, the polynucleic acid molecule hybridizes to a target region that is at either the 5′ intron-exon junction or the 3′ exon-intron junction of exon 8, 23, 35, 43, 44, 45, 50, 51, 52, 53, or 55 of the DMD gene.

In some cases, the polynucleic acid molecule hybridizes to a target region that is at the 5′ intron-exon junction of at least one of exon 3, 4, 5, 6, 7, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, and 63 of the DMD gene. In some cases, the polynucleic acid molecule hybridizes to a target region that is at the 5′ intron-exon junction of exon 8, 23, 35, 43, 44, 45, 50, 51, 52, 53, or 55 of the DMD gene. In some cases, the polynucleic acid molecule hybridizes to a target region that is at the 5′ intron-exon junction of exon 8 of the DMD gene. In some cases, the polynucleic acid molecule hybridizes to a target region that is at the 5′ intron-exon junction of exon 23 of the DMD gene. In some cases, the polynucleic acid molecule hybridizes to a target region that is at the 5′ intron-exon junction of exon 35 of the DMD gene. In some cases, the polynucleic acid molecule hybridizes to a target region that is at the 5′ intron-exon junction of exon 43 of the DMD gene. In some cases, the polynucleic acid molecule hybridizes to a target region that is at the 5′ intron-exon junction of exon 44 of the DMD gene. In some cases, the polynucleic acid molecule hybridizes to a target region that is at the 5′ intron-exon junction of exon 45 of the DMD gene. In some cases, the polynucleic acid molecule hybridizes to a target region that is at the 5′ intron-exon junction of exon 50 of the DMD gene. In some cases, the polynucleic acid molecule hybridizes to a target region that is at the 5′ intron-exon junction of exon 51 of the DMD gene. In some cases, the polynucleic acid molecule hybridizes to a target region that is at the 5′ intron-exon junction of exon 52 of the DMD gene. In some cases, the polynucleic acid molecule hybridizes to a target region that is at the 5′ intron-exon junction of exon 53 of the DMD gene. In some cases, the polynucleic acid molecule hybridizes to a target region that is at the 5′ intron-exon junction of exon 55 of the DMD gene.

In some cases, the polynucleic acid molecule hybridizes to a target region that is at the 3′ exon-intron junction of at least one of exon 3, 4, 5, 6, 7, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, and 63 of the DMD gene. In some cases, the polynucleic acid molecule hybridizes to a target region that is at the 3′ exon-intron junction of exon 8, 23, 35, 43, 44, 45, 50, 51, 52, 53, or 55 of the DMD gene. In some cases, the polynucleic acid molecule hybridizes to a target region that is at the 3′ exon-intron junction of exon 8 of the DMD gene. In some cases, the polynucleic acid molecule hybridizes to a target region that is at the 3′ exon-intron junction of exon 23 of the DMD gene. In some cases, the polynucleic acid molecule hybridizes to a target region that is at the 3′ exon-intron junction of exon 35 of the DMD gene. In some cases, the polynucleic acid molecule hybridizes to a target region that is at the 3′ exon-intron junction of exon 43 of the DMD gene. In some cases, the polynucleic acid molecule hybridizes to a target region that is at the 3′ exon-intron junction of exon 44 of the DMD gene. In some cases, the polynucleic acid molecule hybridizes to a target region that is at the 3′ exon-intron junction of exon 45 of the DMD gene. In some cases, the polynucleic acid molecule hybridizes to a target region that is at the 3′ exon-intron junction of exon 50 of the DMD gene. In some cases, the polynucleic acid molecule hybridizes to a target region that is at the 3′ exon-intron junction of exon 51 of the DMD gene. In some cases, the polynucleic acid molecule hybridizes to a target region that is at the 3′ exon-intron junction of exon 52 of the DMD gene. In some cases, the polynucleic acid molecule hybridizes to a target region that is at the 3′ exon-intron junction of exon 53 of the DMD gene. In some cases, the polynucleic acid molecule hybridizes to a target region that is at the 3′ exon-intron junction of exon 55 of the DMD gene.

In some instances, a polynucleic acid molecule described herein targets a splice site of exon 3, 4, 5, 6, 7, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, or 63 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets a splice site of exon 8, 23, 35, 43, 44, 45, 50, 51, 52, 53, or 55 of the DMD gene. In some cases, a polynucleic acid molecule described herein targets a splice site of exon 8 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets a splice site of exon 23 of the DMD gene. In some cases, a polynucleic acid molecule described herein targets a splice site of exon 35 of the DMD gene. In some cases, a polynucleic acid molecule described herein targets a splice site of exon 43 of the DMD gene. In some cases, a polynucleic acid molecule described herein targets a splice site of exon 44 of the DMD gene. In some cases, a polynucleic acid molecule described herein targets a splice site of exon 45 of the DMD gene.

In some instances, a polynucleic acid molecule described herein targets a splice site of exon 48 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets a splice site of exon 49 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets a splice site of exon 50 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets a splice site of exon 51 of the DMD gene. In some cases, a polynucleic acid molecule described herein targets a splice site of exon 52 of the DMD gene. In some cases, a polynucleic acid molecule described herein targets a splice site of exon 53 of the DMD gene. In some cases, a polynucleic acid molecule described herein targets a splice site of exon 55 of the DMD gene. As used herein, a splice site includes a canonical splice site, a cryptic splice site or an alternative splice site that is capable of inducing an insertion, deletion, duplication, or alteration in an incorrectly spliced mRNA transcript to induce exon skipping or exon inclusion.

In some embodiments, a polynucleic acid molecule described herein target a partially spliced mRNA sequence comprising additional exons involved in Duchenne muscular dystrophy such as exon 3, 4, 5, 6, 7, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, or 63.

In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nucleotides (nt), 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt upstream (or from the 5′) of exon 3, 4, 5, 6, 7, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, or 63 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nt, 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt upstream (or from the 5′) of exon 8, 23, 35, 43, 44, 45, 50, 51, 52, 53, or 55 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nt, 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt upstream (or from the 5′) of exon 8 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nt, 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt upstream (or from the 5′) of exon 23 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nt, 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt upstream (or from the 5′) of exon 35 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nt, 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt upstream (or from the 5′) of exon 43 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nt, 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt upstream (or from the 5′) of exon 44 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nt, 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt upstream (or from the 5′) of exon 45 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nucleotides (nt), 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt upstream (or from the 5′) of exon 48 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nucleotides (nt), 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt upstream (or from the 5′) of exon 49 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nucleotides (nt), 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt upstream (or from the 5′) of exon 50 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nucleotides (nt), 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt upstream (or from the 5′) of exon 51 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nucleotides (nt), 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt upstream (or from the 5′) of exon 52 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nt, 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt upstream (or from the 5′) of exon 53 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nt, 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt upstream (or from the 5′) of exon 55 of the DMD gene.

In some instances, the polynucleic acid molecule hybridizes to a target region that is upstream (or 5′) to at least one of exon 3, 4, 5, 6, 7, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, and 63 of the DMD gene. In some instances, the polynucleic acid molecule hybridizes to a target region that is upstream (or 5′) to at least one of exon 8, 23, 35, 43, 44, 45, 50, 51, 52, 53, or 55 of the DMD gene. In some instances, the polynucleic acid molecule hybridizes to a target region that is about 5, 10, 15, 20, 50, 100, 200, 300, 400 or 500 bp upstream (or 5′) to at least one of exon 3, 4, 5, 6, 7, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, and 63 of the DMD gene.

In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nucleotides (nt), 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt downstream (or from the 3′) of exon 3, 4, 5, 6, 7, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, or 63 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nucleotides (nt), 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt downstream (or from the 3′) of exon 8, 23, 35, 43, 44, 45, 50, 51, 52, 53, or 55 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nucleotides (nt), 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt downstream (or from the 3′) of exon 8 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nucleotides (nt), 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt downstream (or from the 3′) of exon 23 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nucleotides (nt), 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt downstream (or from the 3′) of exon 35 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nucleotides (nt), 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt downstream (or from the 3′) of exon 43 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nucleotides (nt), 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt downstream (or from the 3′) of exon 44 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nucleotides (nt), 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt downstream (or from the 3′) of exon 45 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nucleotides (nt), 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt downstream (or from the 3′) of exon 48 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nucleotides (nt), 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt downstream (or from the 3′) of exon 49 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nucleotides (nt), 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt downstream (or from the 3′) of exon 50 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nucleotides (nt), 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt downstream (or from the 3′) of exon 51 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nucleotides (nt), 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt downstream (or from the 3′) of exon 52 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nucleotides (nt), 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt downstream (or from the 3′) of exon 53 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets a region at least 1000 nucleotides (nt), 500 nt, 400 nt, 300 nt, 200 nt, 100 nt, 80 nt, 60 nt, 50 nt, 40 nt, 30 nt, 20 nt, 10 nt, or 5 nt downstream (or from the 3′) of exon 55 of the DMD gene.

In some instances, the polynucleic acid molecule hybridizes to a target region that is downstream (or 3′) to at least one of exon 3, 4, 5, 6, 7, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, and 63 of the DMD gene. In some instances, the polynucleic acid molecule hybridizes to a target region that is about 5, 10, 15, 20, 50, 100, 200, 300, 400 or 500 bp downstream (or 3′) to at least one of exon 3, 4, 5, 6, 7, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, and 63 of the DMD gene. In some instances, the polynucleic acid molecule hybridizes to a target region that is about 5, 10, 15, 20, 50, 100, 200, 300, 400 or 500 bp downstream (or 3′) to at least one of exon 8, 23, 35, 43, 44, 45, 50, 51, 52, 53, or 55 of the DMD gene.

In some instances, a polynucleic acid molecule described herein targets an internal region within exon 3, 4, 5, 6, 7, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, or 63 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets an internal region within exon 8, 23, 35, 43, 44, 45, 50, 51, 52, 53, or 55 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets an internal region within exon 8 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets an internal region within exon 23 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets an internal region within exon 35 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets an internal region within exon 43 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets an internal region within exon 44 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets an internal region within exon 45 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets an internal region within exon 48 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets an internal region within exon 49 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets an internal region within exon 50 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets an internal region within exon 51 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets an internal region within exon 52 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets an internal region within exon 53 of the DMD gene. In some instances, a polynucleic acid molecule described herein targets an internal region within exon 55 of the DMD gene.

In some instances, the polynucleic acid molecule hybridizes to a target region that is within at least one of exon 3, 4, 5, 6, 7, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, and 63 of the DMD gene. In some instances, the polynucleic acid molecule hybridizes to a target region that is within at least one of exon 8, 23, 35, 43, 44, 45, 50, 51, 52, 53, or 55 of the DMD gene.

In some embodiments, a polynucleic acid molecule described herein targets a partially spliced mRNA sequence comprising exon 51. In some instances, the polynucleic acid molecule hybridizes to a target region that is upstream (or 5′) to exon 51. In some instances, the polynucleic acid molecule hybridizes to a target region that is about 5, 10, 15, 20, 50, 100, 200, 300, 400 or 500 bp upstream (or 5′) to exon 51. In some instances, the polynucleic acid molecule hybridizes to a target region that is downstream (or 3′) to exon 51. In some instances, the polynucleic acid molecule hybridizes to a target region that is about 5, 10, 15, 20, 50, 100, 200, 300, 400 or 500 bp downstream (or 3′) to exon 51.

In some instances, the polynucleic acid molecule hybridizes to a target region that is within exon 51. In some instances, the polynucleic acid molecule hybridizes to a target region that is at either the 5′ intron-exon 51 junction or the 3′ exon 51-intron junction.

In some embodiments, the polynucleic acid molecule comprises a sequence having at least 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99%, or 100% sequence identity to a target sequence of interest. In some embodiments, the polynucleic acid molecule comprises a sequence having at least 50% sequence identity to a target sequence of interest. In some embodiments, the polynucleic acid molecule comprises a sequence having at least 60% sequence identity to a target sequence of interest. In some embodiments, the polynucleic acid molecule comprises a sequence having at least 70% sequence identity to a target sequence of interest. In some embodiments, the polynucleic acid molecule comprises a sequence having at least 75% sequence identity to a target sequence of interest. In some embodiments, the polynucleic acid molecule comprises a sequence having at least 80% sequence identity to a target sequence of interest. In some embodiments, the polynucleic acid molecule comprises a sequence having at least 85% sequence identity to a target sequence of interest. In some embodiments, the polynucleic acid molecule comprises a sequence having at least 90% sequence identity to a target sequence of interest. In some embodiments, the polynucleic acid molecule comprises a sequence having at least 95% sequence identity to a target sequence of interest. In some embodiments, the polynucleic acid molecule comprises a sequence having at least 96% sequence identity to a target sequence of interest. In some embodiments, the polynucleic acid molecule comprises a sequence having at least 97% sequence identity to a target sequence of interest. In some embodiments, the polynucleic acid molecule comprises a sequence having at least 98% sequence identity to a target sequence of interest. In some embodiments, the polynucleic acid molecule comprises a sequence having at least 99% sequence identity to a target sequence of interest. In some embodiments, the polynucleic acid molecule consists of a target sequence of interest.

In some embodiments, the polynucleic acid molecule comprises a first polynucleotide and a second polynucleotide. In some instances, the first polynucleotide comprises a sequence having at least 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99%, or 100% sequence identity to a target sequence of interest. In some cases, the second polynucleotide comprises a sequence having at least 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99%, or 100% sequence identity to a target sequence of interest. In some cases, the polynucleic acid molecule comprises a first polynucleotide having at least 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99%, or 100% sequence identity to a target sequence of interest and a second polynucleotide having at least 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99%, or 100% sequence identity to a target sequence of interest.

In some embodiments, the polynucleic acid molecule described herein comprises RNA or DNA. In some cases, the polynucleic acid molecule comprises RNA. In some instances, RNA comprises short interfering RNA (siRNA), short hairpin RNA (shRNA), microRNA (miRNA), double-stranded RNA (dsRNA), transfer RNA (tRNA), ribosomal RNA (rRNA), or heterogeneous nuclear RNA (hnRNA). In some instances, RNA comprises shRNA. In some instances, RNA comprises miRNA. In some instances, RNA comprises dsRNA. In some instances, RNA comprises tRNA. In some instances, RNA comprises rRNA. In some instances, RNA comprises hnRNA. In some instances, the RNA comprises siRNA. In some instances, the polynucleic acid molecule comprises siRNA.

In some embodiments, the polynucleic acid molecule is from about 10 to about 50 nucleotides in length. In some instances, the polynucleic acid molecule is from about 10 to about 30, from about 15 to about 30, from about 18 to about 25, form about 18 to about 24, from about 19 to about 23, or from about 20 to about 22 nucleotides in length.

In some embodiments, the polynucleic acid molecule is about 50 nucleotides in length. In some instances, the polynucleic acid molecule is about 45 nucleotides in length. In some instances, the polynucleic acid molecule is about 40 nucleotides in length. In some instances, the polynucleic acid molecule is about 35 nucleotides in length. In some instances, the polynucleic acid molecule is about 30 nucleotides in length. In some instances, the polynucleic acid molecule is about 25 nucleotides in length. In some instances, the polynucleic acid molecule is about 20 nucleotides in length. In some instances, the polynucleic acid molecule is about 19 nucleotides in length. In some instances, the polynucleic acid molecule is about 18 nucleotides in length. In some instances, the polynucleic acid molecule is about 17 nucleotides in length. In some instances, the polynucleic acid molecule is about 16 nucleotides in length. In some instances, the polynucleic acid molecule is about 15 nucleotides in length. In some instances, the polynucleic acid molecule is about 14 nucleotides in length. In some instances, the polynucleic acid molecule is about 13 nucleotides in length. In some instances, the polynucleic acid molecule is about 12 nucleotides in length. In some instances, the polynucleic acid molecule is about 11 nucleotides in length. In some instances, the polynucleic acid molecule is about 10 nucleotides in length. In some instances, the polynucleic acid molecule is between about 10 and about 50 nucleotides in length. In some instances, the polynucleic acid molecule is between about 10 and about 45 nucleotides in length. In some instances, the polynucleic acid molecule is between about 10 and about 40 nucleotides in length. In some instances, the polynucleic acid molecule is between about 10 and about 35 nucleotides in length. In some instances, the polynucleic acid molecule is between about 10 and about 30 nucleotides in length. In some instances, the polynucleic acid molecule is between about 10 and about 25 nucleotides in length. In some instances, the polynucleic acid molecule is between about 10 and about 20 nucleotides in length. In some instances, the polynucleic acid molecule is between about 15 and about 25 nucleotides in length. In some instances, the polynucleic acid molecule is between about 15 and about 30 nucleotides in length. In some instances, the polynucleic acid molecule is between about 12 and about 30 nucleotides in length.

In some embodiments, the polynucleic acid molecule comprises a first polynucleotide. In some instances, the polynucleic acid molecule comprises a second polynucleotide. In some instances, the polynucleic acid molecule comprises a first polynucleotide and a second polynucleotide. In some instances, the first polynucleotide is a sense strand or passenger strand. In some instances, the second polynucleotide is an antisense strand or guide strand.

In some embodiments, the polynucleic acid molecule is a first polynucleotide. In some embodiments, the first polynucleotide is from about 10 to about 50 nucleotides in length. In some instances, the first polynucleotide is from about 10 to about 30, from about 15 to about 30, from about 18 to about 25, form about 18 to about 24, from about 19 to about 23, or from about 20 to about 22 nucleotides in length.

In some instances, the first polynucleotide is about 50 nucleotides in length. In some instances, the first polynucleotide is about 45 nucleotides in length. In some instances, the first polynucleotide is about 40 nucleotides in length. In some instances, the first polynucleotide is about 35 nucleotides in length. In some instances, the first polynucleotide is about 30 nucleotides in length. In some instances, the first polynucleotide is about 25 nucleotides in length. In some instances, the first polynucleotide is about 20 nucleotides in length. In some instances, the first polynucleotide is about 19 nucleotides in length. In some instances, the first polynucleotide is about 18 nucleotides in length. In some instances, the first polynucleotide is about 17 nucleotides in length. In some instances, the first polynucleotide is about 16 nucleotides in length. In some instances, the first polynucleotide is about 15 nucleotides in length. In some instances, the first polynucleotide is about 14 nucleotides in length. In some instances, the first polynucleotide is about 13 nucleotides in length. In some instances, the first polynucleotide is about 12 nucleotides in length. In some instances, the first polynucleotide is about 11 nucleotides in length. In some instances, the first polynucleotide is about 10 nucleotides in length. In some instances, the first polynucleotide is between about 10 and about 50 nucleotides in length. In some instances, the first polynucleotide is between about 10 and about 45 nucleotides in length. In some instances, the first polynucleotide is between about 10 and about 40 nucleotides in length. In some instances, the first polynucleotide is between about 10 and about 35 nucleotides in length. In some instances, the first polynucleotide is between about 10 and about 30 nucleotides in length. In some instances, the first polynucleotide is between about 10 and about 25 nucleotides in length. In some instances, the first polynucleotide is between about 10 and about 20 nucleotides in length. In some instances, the first polynucleotide is between about 15 and about 25 nucleotides in length. In some instances, the first polynucleotide is between about 15 and about 30 nucleotides in length. In some instances, the first polynucleotide is between about 12 and about 30 nucleotides in length.

In some embodiments, the polynucleic acid molecule is a second polynucleotide. In some embodiments, the second polynucleotide is from about 10 to about 50 nucleotides in length. In some instances, the second polynucleotide is from about 10 to about 30, from about 15 to about 30, from about 18 to about 25, form about 18 to about 24, from about 19 to about 23, or from about 20 to about 22 nucleotides in length.

In some instances, the second polynucleotide is about 50 nucleotides in length. In some instances, the second polynucleotide is about 45 nucleotides in length. In some instances, the second polynucleotide is about 40 nucleotides in length. In some instances, the second polynucleotide is about 35 nucleotides in length. In some instances, the second polynucleotide is about 30 nucleotides in length. In some instances, the second polynucleotide is about 25 nucleotides in length. In some instances, the second polynucleotide is about 20 nucleotides in length. In some instances, the second polynucleotide is about 19 nucleotides in length. In some instances, the second polynucleotide is about 18 nucleotides in length. In some instances, the second polynucleotide is about 17 nucleotides in length. In some instances, the second polynucleotide is about 16 nucleotides in length. In some instances, the second polynucleotide is about 15 nucleotides in length. In some instances, the second polynucleotide is about 14 nucleotides in length. In some instances, the second polynucleotide is about 13 nucleotides in length. In some instances, the second polynucleotide is about 12 nucleotides in length. In some instances, the second polynucleotide is about 11 nucleotides in length. In some instances, the second polynucleotide is about 10 nucleotides in length. In some instances, the second polynucleotide is between about 10 and about 50 nucleotides in length. In some instances, the second polynucleotide is between about 10 and about 45 nucleotides in length. In some instances, the second polynucleotide is between about 10 and about 40 nucleotides in length. In some instances, the second polynucleotide is between about 10 and about 35 nucleotides in length. In some instances, the second polynucleotide is between about 10 and about 30 nucleotides in length. In some instances, the second polynucleotide is between about 10 and about 25 nucleotides in length. In some instances, the second polynucleotide is between about 10 and about 20 nucleotides in length. In some instances, the second polynucleotide is between about 15 and about 25 nucleotides in length. In some instances, the second polynucleotide is between about 15 and about 30 nucleotides in length. In some instances, the second polynucleotide is between about 12 and about 30 nucleotides in length.

In some embodiments, the polynucleic acid molecule comprises a first polynucleotide and a second polynucleotide. In some instances, the polynucleic acid molecule further comprises a blunt terminus, an overhang, or a combination thereof. In some instances, the blunt terminus is a 5′ blunt terminus, a 3′ blunt terminus, or both. In some cases, the overhang is a 5′ overhang, 3′ overhang, or both. In some cases, the overhang comprises 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10 non-base pairing nucleotides. In some cases, the overhang comprises 1, 2, 3, 4, 5, or 6 non-base pairing nucleotides. In some cases, the overhang comprises 1, 2, 3, or 4 non-base pairing nucleotides. In some cases, the overhang comprises 1 non-base pairing nucleotide. In some cases, the overhang comprises 2 non-base pairing nucleotides. In some cases, the overhang comprises 3 non-base pairing nucleotides. In some cases, the overhang comprises 4 non-base pairing nucleotides.

In some embodiments, the sequence of the polynucleic acid molecule is at least 40%, 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, 98%, 99%, or 99.5% complementary to a target sequence described herein. In some embodiments, the sequence of the polynucleic acid molecule is at least 50% complementary to a target sequence described herein. In some embodiments, the sequence of the polynucleic acid molecule is at least 60% complementary to a target sequence described herein. In some embodiments, the sequence of the polynucleic acid molecule is at least 70% complementary to a target sequence described herein. In some embodiments, the sequence of the polynucleic acid molecule is at least 80% complementary to a target sequence described herein. In some embodiments, the sequence of the polynucleic acid molecule is at least 90% complementary to a target sequence described herein. In some embodiments, the sequence of the polynucleic acid molecule is at least 95% complementary to a target sequence described herein. In some embodiments, the sequence of the polynucleic acid molecule is at least 99% complementary to a target sequence described herein. In some instances, the sequence of the polynucleic acid molecule is 100% complementary to a target sequence described herein.

In some embodiments, the sequence of the polynucleic acid molecule has 5 or less mismatches to a target sequence described herein. In some embodiments, the sequence of the polynucleic acid molecule has 4 or less mismatches to a target sequence described herein. In some instances, the sequence of the polynucleic acid molecule has 3 or less mismatches to a target sequence described herein. In some cases, the sequence of the polynucleic acid molecule has 2 or less mismatches to a target sequence described herein. In some cases, the sequence of the polynucleic acid molecule has 1 or less mismatches to a target sequence described herein.

In some embodiments, the specificity of the polynucleic acid molecule that hybridizes to a target sequence described herein is a 95%, 98%, 99%, 99.5% or 100% sequence complementarity of the polynucleic acid molecule to a target sequence. In some instances, the hybridization is a high stringent hybridization condition.

In some embodiments, the polynucleic acid molecule has reduced off-target effect. In some instances, “off-target” or “off-target effects” refer to any instance in which a polynucleic acid polymer directed against a given target causes an unintended effect by interacting either directly or indirectly with another mRNA sequence, a DNA sequence or a cellular protein or other moiety. In some instances, an “off-target effect” occurs when there is a simultaneous degradation of other transcripts due to partial homology or complementarity between that other transcript and the sense and/or antisense strand of the polynucleic acid molecule.

In some embodiments, the polynucleic acid molecule comprises natural or synthetic or artificial nucleotide analogues or bases. In some cases, the polynucleic acid molecule comprises combinations of DNA, RNA and/or nucleotide analogues. In some instances, the synthetic or artificial nucleotide analogues or bases comprise modifications at one or more of ribose moiety, phosphate moiety, nucleoside moiety, or a combination thereof.

In some embodiments, nucleotide analogues or artificial nucleotide base comprise a nucleic acid with a modification at a 2′ hydroxyl group of the ribose moiety. In some instances, the modification includes an H, OR, R, halo, SH, SR, NH2, NHR, NR2, or CN, wherein R is an alkyl moiety. Exemplary alkyl moiety includes, but is not limited to, halogens, sulfurs, thiols, thioethers, thioesters, amines (primary, secondary, or tertiary), amides, ethers, esters, alcohols and oxygen. In some instances, the alkyl moiety further comprises a modification. In some instances, the modification comprises an azo group, a keto group, an aldehyde group, a carboxyl group, a nitro group, a nitroso, group, a nitrile group, a heterocycle (e.g., imidazole, hydrazino or hydroxylamino) group, an isocyanate or cyanate group, or a sulfur containing group (e.g., sulfoxide, sulfone, sulfide, and disulfide). In some instances, the alkyl moiety further comprises a hetero substitution. In some instances, the carbon of the heterocyclic group is substituted by a nitrogen, oxygen or sulfur. In some instances, the heterocyclic substitution includes but is not limited to, morpholino, imidazole, and pyrrolidino.

In some instances, the modification at the 2′ hydroxyl group is a 2′-O-methyl modification or a 2′-O-methoxyethyl (2′-O-MOE) modification. In some cases, the 2′-O-methyl modification adds a methyl group to the 2′ hydroxyl group of the ribose moiety whereas the 2′O-methoxyethyl modification adds a methoxyethyl group to the 2′ hydroxyl group of the ribose moiety. Exemplary chemical structures of a 2′-O-methyl modification of an adenosine molecule and 2′O-methoxyethyl modification of an uridine are illustrated below.

In some instances, the modification at the 2′ hydroxyl group is a 2′-O-aminopropyl modification in which an extended amine group comprising a propyl linker binds the amine group to the 2′ oxygen. In some instances, this modification neutralizes the phosphate derived overall negative charge of the oligonucleotide molecule by introducing one positive charge from the amine group per sugar and thereby improves cellular uptake properties due to its zwitterionic properties. An exemplary chemical structure of a 2′-O-aminopropyl nucleoside phosphoramidite is illustrated below.

In some instances, the modification at the 2′ hydroxyl group is a locked or bridged ribose modification (e.g., locked nucleic acid or LNA) in which the oxygen molecule bound at the 2′ carbon is linked to the 4′ carbon by a methylene group, thus forming a 2′-C,4′-C-oxy-methylene-linked bicyclic ribonucleotide monomer. Exemplary representations of the chemical structure of LNA are illustrated below. The representation shown to the left highlights the chemical connectivities of an LNA monomer. The representation shown to the right highlights the locked 3′-endo (³E) conformation of the furanose ring of an LNA monomer.

In some instances, the modification at the 2′ hydroxyl group comprises ethylene nucleic acids (ENA) such as for example 2′-4′-ethylene-bridged nucleic acid, which locks the sugar conformation into a C₃′-endo sugar puckering conformation. ENA are part of the bridged nucleic acids class of modified nucleic acids that also comprises LNA. Exemplary chemical structures of the ENA and bridged nucleic acids are illustrated below.

In some embodiments, additional modifications at the 2′ hydroxyl group include 2′-deoxy, T-deoxy-2′-fluoro, 2′-O-aminopropyl (2′-O-AP), 2′-O-dimethylaminoethyl (2′-O-DMAOE), 2′-O-dimethylaminopropyl (2′-O-DMAP), T-O-dimethylaminoethyloxyethyl (2′-O-DMAEOE), or 2′-O—N-methylacetamido (2′-O-NMA).

In some embodiments, nucleotide analogues comprise modified bases such as, but not limited to, 5-propynyluridine, 5-propynylcytidine, 6-methyladenine, 6-methylguanine, N,N,-dimethyladenine, 2-propyladenine, 2propylguanine, 2-aminoadenine, 1-methylinosine, 3-methyluridine, 5-methylcytidine, 5-methyluridine and other nucleotides having a modification at the 5 position, 5-(2-amino) propyl uridine, 5-halocytidine, 5-halouridine, 4-acetylcytidine, 1-methyladenosine, 2-methyladenosine, 3-methylcytidine, 6-methyluridine, 2-methylguanosine, 7-methylguanosine, 2, 2-dimethylguanosine, 5-methylaminoethyluridine, 5-methyloxyuridine, deazanucleotides such as 7-deaza-adenosine, 6-azouridine, 6-azocytidine, 6-azothymidine, 5-methyl-2-thiouridine, other thio bases such as 2-thiouridine and 4-thiouridine and 2-thiocytidine, dihydrouridine, pseudouridine, queuosine, archaeosine, naphthyl and substituted naphthyl groups, any O- and N-alkylated purines and pyrimidines such as N6-methyladenosine, 5-methylcarbonylmethyluridine, uridine 5-oxyacetic acid, pyridine-4-one, pyridine-2-one, phenyl and modified phenyl groups such as aminophenol or 2,4, 6-trimethoxy benzene, modified cytosines that act as G-clamp nucleotides, 8-substituted adenines and guanines, 5-substituted uracils and thymines, azapyrimidines, carboxyhydroxyalkyl nucleotides, carboxyalkylaminoalkyi nucleotides, and alkylcarbonylalkylated nucleotides. Modified nucleotides also include those nucleotides that are modified with respect to the sugar moiety, as well as nucleotides having sugars or analogs thereof that are not ribosyl. For example, the sugar moieties, in some cases are or be based on, mannoses, arabinoses, glucopyranoses, galactopyranoses, 4′-thioribose, and other sugars, heterocycles, or carbocycles. The term nucleotide also includes what are known in the art as universal bases. By way of example, universal bases include but are not limited to 3-nitropyrrole, 5-nitroindole, or nebularine.

In some embodiments, nucleotide analogues further comprise morpholinos, peptide nucleic acids (PNAs), methylphosphonate nucleotides, thiolphosphonate nucleotides, 2′-fluoro N3-P5′-phosphoramidites, 5′-anhydrohexitol nucleic acids (HNAs), or a combination thereof. Morpholino or phosphorodiamidate morpholino oligo (PMO) comprises synthetic molecules whose structure mimics natural nucleic acid structure by deviates from the normal sugar and phosphate structures. In some instances, the five member ribose ring is substituted with a six member morpholino ring containing four carbons, one nitrogen and one oxygen. In some cases, the ribose monomers are linked by a phosphordiamidate group instead of a phosphate group. In such cases, the backbone alterations remove all positive and negative charges making morpholinos neutral molecules capable of crossing cellular membranes without the aid of cellular delivery agents such as those used by charged oligonucleotides.

In some embodiments, peptide nucleic acid (PNA) does not contain sugar ring or phosphate linkage and the bases are attached and appropriately spaced by oligoglycine-like molecules, therefore, eliminating a backbone charge.

In some embodiments, one or more modifications optionally occur at the internucleotide linkage. In some instances, modified internucleotide linkage include, but is not limited to, phosphorothioates, phosphorodithioates, methylphosphonates, 5′-alkylenephosphonates, 5′-methylphosphonate, 3′-alkylene phosphonates, borontrifluoridates, borano phosphate esters and selenophosphates of 3′-5′linkage or 2′-5′linkage, phosphotriesters, thionoalkylphosphotriesters, hydrogen phosphonate linkages, alkyl phosphonates, alkylphosphonothioates, arylphosphonothioates, phosphoroselenoates, phosphorodiselenoates, phosphinates, phosphoramidates, 3′-alkylphosphoramidates, aminoalkylphosphoramidates, thionophosphoramidates, phosphoropiperazidates, phosphoroanilothioates, phosphoroanilidates, ketones, sulfones, sulfonamides, carbonates, carbamates, methylenehydrazos, methylenedimethylhydrazos, formacetals, thioformacetals, oximes, methyleneiminos, methylenemethyliminos, thioamidates, linkages with riboacetyl groups, aminoethyl glycine, silyl or siloxane linkages, alkyl or cycloalkyl linkages with or without heteroatoms of, for example, 1 to 10 carbons that are saturated or unsaturated and/or substituted and/or contain heteroatoms, linkages with morpholino structures, amides, polyamides wherein the bases are attached to the aza nitrogens of the backbone directly or indirectly, and combinations thereof. Phosphorothioate antisene oligonucleotides (PS ASO) are antisense oligonucleotides comprising a phosphorothioate linkage. An exemplary PS ASO is illustrated below.

In some instances, the modification is a methyl or thiol modification such as methylphosphonate or thiolphosphonate modification. Exemplary thiolphosphonate nucleotide (left) and methylphosphonate nucleotide (right) are illustrated below.

In some instances, a modified nucleotide includes, but is not limited to, 2′-fluoro N3-P5′-phosphoramidites illustrated as:

In some instances, a modified nucleotide includes, but is not limited to, hexitol nucleic acid (or 1′, 5′-anhydrohexitol nucleic acids (HNA)) illustrated as:

In some embodiments, one or more modifications further optionally include modifications of the ribose moiety, phosphate backbone and the nucleoside, or modifications of the nucleotide analogues at the 3′ or the 5′ terminus. For example, the 3′ terminus optionally include a 3′ cationic group, or by inverting the nucleoside at the 3′-terminus with a 3′-3′ linkage. In another alternative, the 3′-terminus is optionally conjugated with an aminoalkyl group, e.g., a 3′ C5-aminoalkyl dT. In an additional alternative, the 3′-terminus is optionally conjugated with an abasic site, e.g., with an apurinic or apyrimidinic site. In some instances, the 5′-terminus is conjugated with an aminoalkyl group, e.g., a 5′-O-alkylamino substituent. In some cases, the 5′-terminus is conjugated with an abasic site, e.g., with an apurinic or apyrimidinic site.

In some embodiments, the polynucleic acid molecule comprises one or more of the artificial nucleotide analogues described herein. In some instances, the polynucleic acid molecule comprises 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 20, 25, or more of the artificial nucleotide analogues described herein. In some embodiments, the artificial nucleotide analogues include 2′-O-methyl, 2′-O-methoxyethyl (2′-O-MOE), 2′-O-aminopropyl, 2′-deoxy, T-deoxy-2′-fluoro, 2′-O-aminopropyl (2′-O-AP), 2′-O-dimethylaminoethyl (2′-O-DMAOE), 2′-O-dimethylaminopropyl (2′-O-DMAP), T-O-dimethylaminoethyloxyethyl (2′-O-DMAEOE), or 2′-O—N-methylacetamido (2′-O-NMA) modified, LNA, ENA, PNA, HNA, morpholino, methylphosphonate nucleotides, thiolphosphonate nucleotides, 2′-fluoro N3-P5′-phosphoramidites, or a combination thereof. In some instances, the polynucleic acid molecule comprises 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 20, 25, or more of the artificial nucleotide analogues selected from 2′-O-methyl, 2′-O-methoxyethyl(2′-O-MOE), 2′-O-aminopropyl, 2′-deoxy, T-deoxy-2′-fluoro, 2′-O-aminopropyl (2′-O-AP), 2′-O-dimethylaminoethyl (2′-O-DMAOE), 2′-O-dimethylaminopropyl (2′-O-DMAP), T-O-dimethylaminoethyloxyethyl (2′-O-DMAEOE), or 2′-O—N-methylacetamido (2′-O-NMA) modified, LNA, ENA, PNA, HNA, morpholino, methylphosphonate nucleotides, thiolphosphonate nucleotides, 2′-fluoro N3-P5′-phosphoramidites, or a combination thereof. In some instances, the polynucleic acid molecule comprises 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 20, 25, or more of 2′-O-methyl modified nucleotides. In some instances, the polynucleic acid molecule comprises 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 20, 25, or more of 2′-O-methoxyethyl (2′-O-MOE) modified nucleotides. In some instances, the polynucleic acid molecule comprises 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 20, 25, or more of thiolphosphonate nucleotides.

In some instances, the polynucleic acid molecule comprises at least one of: from about 5% to about 100% modification, from about 10% to about 100% modification, from about 20% to about 100% modification, from about 30% to about 100% modification, from about 40% to about 100% modification, from about 50% to about 100% modification, from about 60% to about 100% modification, from about 70% to about 100% modification, from about 80% to about 100% modification, and from about 90% to about 100% modification.

In some cases, the polynucleic acid molecule comprises at least one of: from about 10% to about 90% modification, from about 20% to about 90% modification, from about 30% to about 90% modification, from about 40% to about 90% modification, from about 50% to about 90% modification, from about 60% to about 90% modification, from about 70% to about 90% modification, and from about 80% to about 100% modification.

In some cases, the polynucleic acid molecule comprises at least one of: from about 10% to about 80% modification, from about 20% to about 80% modification, from about 30% to about 80% modification, from about 40% to about 80% modification, from about 50% to about 80% modification, from about 60% to about 80% modification, and from about 70% to about 80% modification.

In some instances, the polynucleic acid molecule comprises at least one of: from about 10% to about 70% modification, from about 20% to about 70% modification, from about 30% to about 70% modification, from about 40% to about 70% modification, from about 50% to about 70% modification, and from about 60% to about 70% modification.

In some instances, the polynucleic acid molecule comprises at least one of: from about 10% to about 60% modification, from about 20% to about 60% modification, from about 30% to about 60% modification, from about 40% to about 60% modification, and from about 50% to about 60% modification.

In some cases, the polynucleic acid molecule comprises at least one of: from about 10% to about 50% modification, from about 20% to about 50% modification, from about 30% to about 50% modification, and from about 40% to about 50% modification.

In some cases, the polynucleic acid molecule comprises at least one of: from about 10% to about 40% modification, from about 20% to about 40% modification, and from about 30% to about 40% modification.

In some cases, the polynucleic acid molecule comprises at least one of: from about 10% to about 30% modification, and from about 20% to about 30% modification.

In some cases, the polynucleic acid molecule comprises from about 10% to about 20% modification.

In some cases, the polynucleic acid molecule comprises from about 15% to about 90%, from about 20% to about 80%, from about 30% to about 70%, or from about 40% to about 60% modifications.

In additional cases, the polynucleic acid molecule comprises at least about 15%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 95%, or 99% modification.

In some embodiments, the polynucleic acid molecule comprises at least about 1, about 2, about 3, about 4, about 5, about 6, about 7, about 8, about 9, about 10, about 11, about 12, about 13, about 14, about 15, about 16, about 17, about 18, about 19, about 20, about 21, about 22 or more modifications.

In some instances, the polynucleic acid molecule comprises at least about 1, about 2, about 3, about 4, about 5, about 6, about 7, about 8, about 9, about 10, about 11, about 12, about 13, about 14, about 15, about 16, about 17, about 18, about 19, about 20, about 21, about 22 or more modified nucleotides.

In some instances, from about 5% to about 100% of the polynucleic acid molecule comprise the artificial nucleotide analogues described herein. In some instances, about 5%, 10%, 15%, 20%, 25%, 30%, 35%, 40%, 45%, 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95% or 100% of the polynucleic acid molecule comprise the artificial nucleotide analogues described herein. In some instances, about 5% of a polynucleic acid molecule comprise the artificial nucleotide analogues described herein. In some instances, about 10% of a polynucleic acid molecule comprise the artificial nucleotide analogues described herein. In some instances, about 15% of a polynucleic acid molecule comprise the artificial nucleotide analogues described herein. In some instances, about 20% of a polynucleic acid molecule comprise the artificial nucleotide analogues described herein. In some instances, about 25% of a polynucleic acid molecule comprise the artificial nucleotide analogues described herein. In some instances, about 30% of a polynucleic acid molecule comprise the artificial nucleotide analogues described herein. In some instances, about 35% of a polynucleic acid molecule comprise the artificial nucleotide analogues described herein. In some instances, about 40% of a polynucleic acid molecule comprise the artificial nucleotide analogues described herein. In some instances, about 45% of a polynucleic acid molecule comprise the artificial nucleotide analogues described herein. In some instances, about 50% of a polynucleic acid molecule comprise the artificial nucleotide analogues described herein. In some instances, about 55% of a polynucleic acid molecule comprise the artificial nucleotide analogues described herein. In some instances, about 60% of a polynucleic acid molecule comprise the artificial nucleotide analogues described herein. In some instances, about 65% of a polynucleic acid molecule comprise the artificial nucleotide analogues described herein. In some instances, about 70% of a polynucleic acid molecule comprise the artificial nucleotide analogues described herein. In some instances, about 75% of a polynucleic acid molecule comprise the artificial nucleotide analogues described herein. In some instances, about 80% of a polynucleic acid molecule comprise the artificial nucleotide analogues described herein. In some instances, about 85% of a polynucleic acid molecule comprise the artificial nucleotide analogues described herein. In some instances, about 90% of a polynucleic acid molecule comprise the artificial nucleotide analogues described herein. In some instances, about 95% of a polynucleic acid molecule comprise the artificial nucleotide analogues described herein. In some instances, about 96% of a polynucleic acid molecule comprise the artificial nucleotide analogues described herein. In some instances, about 97% of a polynucleic acid molecule comprise the artificial nucleotide analogues described herein. In some instances, about 98% of a polynucleic acid molecule comprise the artificial nucleotide analogues described herein. In some instances, about 99% of a polynucleic acid molecule comprise the artificial nucleotide analogues described herein. In some instances, about 100% of a polynucleic acid molecule comprise the artificial nucleotide analogues described herein. In some embodiments, the artificial nucleotide analogues include 2′-O-methyl, 2′-O-methoxyethyl(2′-O-MOE), 2′-O-aminopropyl, 2′-deoxy, T-deoxy-2′-fluoro, 2′-O-aminopropyl (2′-O-AP), 2′-O-dimethylaminoethyl (2′-O-DMAOE), 2′-O-dimethylaminopropyl (2′-O-DMAP), T-O-dimethylaminoethyloxyethyl (2′-O-DMAEOE), or 2′-O—N-methylacetamido (2′-O-NMA) modified, LNA, ENA, PNA, HNA, morpholino, methylphosphonate nucleotides, thiolphosphonate nucleotides, 2′-fluoro N3-P5′-phosphoramidites, or a combination thereof.

In some embodiments, the polynucleic acid molecule comprises from about 1 to about 25 modifications in which the modification comprises an artificial nucleotide analogues described herein. In some embodiments, a polynucleic acid molecule comprises about 1 modification in which the modification comprises an artificial nucleotide analogue described herein. In some embodiments, a polynucleic acid molecule comprises about 2 modifications in which the modifications comprise an artificial nucleotide analogue described herein. In some embodiments, a polynucleic acid molecule comprises about 3 modifications in which the modifications comprise an artificial nucleotide analogue described herein. In some embodiments, a polynucleic acid molecule comprises about 4 modifications in which the modifications comprise an artificial nucleotide analogue described herein. In some embodiments, a polynucleic acid molecule comprises about 5 modifications in which the modifications comprise an artificial nucleotide analogue described herein. In some embodiments, a polynucleic acid molecule comprises about 6 modifications in which the modifications comprise an artificial nucleotide analogue described herein. In some embodiments, a polynucleic acid molecule comprises about 7 modifications in which the modifications comprise an artificial nucleotide analogue described herein. In some embodiments, a polynucleic acid molecule comprises about 8 modifications in which the modifications comprise an artificial nucleotide analogue described herein. In some embodiments, a polynucleic acid molecule comprises about 9 modifications in which the modifications comprise an artificial nucleotide analogue described herein. In some embodiments, a polynucleic acid molecule comprises about 10 modifications in which the modifications comprise an artificial nucleotide analogue described herein. In some embodiments, a polynucleic acid molecule comprises about 11 modifications in which the modifications comprise an artificial nucleotide analogue described herein. In some embodiments, a polynucleic acid molecule comprises about 12 modifications in which the modifications comprise an artificial nucleotide analogue described herein. In some embodiments, a polynucleic acid molecule comprises about 13 modifications in which the modifications comprise an artificial nucleotide analogue described herein. In some embodiments, a polynucleic acid molecule comprises about 14 modifications in which the modifications comprise an artificial nucleotide analogue described herein. In some embodiments, a polynucleic acid molecule comprises about 15 modifications in which the modifications comprise an artificial nucleotide analogue described herein. In some embodiments, a polynucleic acid molecule comprises about 16 modifications in which the modifications comprise an artificial nucleotide analogue described herein. In some embodiments, a polynucleic acid molecule comprises about 17 modifications in which the modifications comprise an artificial nucleotide analogue described herein. In some embodiments, a polynucleic acid molecule comprises about 18 modifications in which the modifications comprise an artificial nucleotide analogue described herein. In some embodiments, a polynucleic acid molecule comprises about 19 modifications in which the modifications comprise an artificial nucleotide analogue described herein. In some embodiments, a polynucleic acid molecule comprises about 20 modifications in which the modifications comprise an artificial nucleotide analogue described herein. In some embodiments, a polynucleic acid molecule comprises about 21 modifications in which the modifications comprise an artificial nucleotide analogue described herein. In some embodiments, a polynucleic acid molecule comprises about 22 modifications in which the modifications comprise an artificial nucleotide analogue described herein. In some embodiments, a polynucleic acid molecule comprises about 23 modifications in which the modifications comprise an artificial nucleotide analogue described herein. In some embodiments, a polynucleic acid molecule comprises about 24 modifications in which the modifications comprise an artificial nucleotide analogue described herein. In some embodiments, a polynucleic acid molecule comprises about 25 modifications in which the modifications comprise an artificial nucleotide analogue described herein.

In some embodiments, a polynucleic acid molecule is assembled from two separate polynucleotides wherein one polynucleotide comprises the sense strand and the second polynucleotide comprises the antisense strand of the polynucleic acid molecule. In other embodiments, the sense strand is connected to the antisense strand via a linker molecule, which in some instances is a polynucleotide linker or a non-nucleotide linker.

In some embodiments, a polynucleic acid molecule comprises a sense strand and antisense strand, wherein pyrimidine nucleotides in the sense strand comprises 2′-O-methylpyrimidine nucleotides and purine nucleotides in the sense strand comprise 2′-deoxy purine nucleotides. In some embodiments, a polynucleic acid molecule comprises a sense strand and antisense strand, wherein pyrimidine nucleotides present in the sense strand comprise 2′-deoxy-2′-fluoro pyrimidine nucleotides and wherein purine nucleotides present in the sense strand comprise 2′-deoxy purine nucleotides.

In some embodiments, a polynucleic acid molecule comprises a sense strand and antisense strand, wherein the pyrimidine nucleotides when present in said antisense strand are 2′-deoxy-2′-fluoro pyrimidine nucleotides and the purine nucleotides when present in said antisense strand are 2′-O-methyl purine nucleotides.

In some embodiments, a polynucleic acid molecule comprises a sense strand and antisense strand, wherein the pyrimidine nucleotides when present in said antisense strand are 2′-deoxy-2′-fluoro pyrimidine nucleotides and wherein the purine nucleotides when present in said antisense strand comprise 2′-deoxy-purine nucleotides.

In some embodiments, a polynucleic acid molecule comprises a sense strand and antisense strand, wherein the sense strand includes a terminal cap moiety at the 5′-end, the 3′-end, or both of the 5′ and 3′ ends of the sense strand. In other embodiments, the terminal cap moiety is an inverted deoxy abasic moiety.

In some embodiments, a polynucleic acid molecule comprises a sense strand and an antisense strand, wherein the antisense strand comprises a phosphate backbone modification at the 3′ end of the antisense strand. In some instances, the phosphate backbone modification is a phosphorothioate.

In some embodiments, a polynucleic acid molecule comprises a sense strand and an antisense strand, wherein the antisense strand comprises a glyceryl modification at the 3′ end of the antisense strand.

In some embodiments, a polynucleic acid molecule comprises a sense strand and an antisense strand, in which the sense strand comprises one or more, for example, about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, or more phosphorothioate internucleotide linkages, and/or one or more (e.g., about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 or more) 2′-deoxy, 2′-O-methyl, 2′-deoxy-2′-fluoro, and/or about one or more (e.g., about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 or more) universal base modified nucleotides, and optionally a terminal cap molecule at the 3′-end, the 5′-end, or both of the 3′- and 5′-ends of the sense strand; and in which the antisense strand comprises about 1 to about 10 or more, specifically about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, or more phosphorothioate internucleotide linkages, and/or one or more (e.g., about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 or more) 2′-deoxy, 2′-O-methyl, 2′-deoxy-2′-fluoro, and/or one or more (e.g., about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 or more) universal base modified nucleotides, and optionally a terminal cap molecule at the 3′-end, the 5′-end, or both of the 3′- and 5′-ends of the antisense strand. In other embodiments, one or more, for example about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or more, pyrimidine nucleotides of the sense and/or antisense strand are chemically-modified with 2′-deoxy, 2′-O-methyl and/or 2′-deoxy-2′-fluoro nucleotides, with or without one or more, for example about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or more, phosphorothioate internucleotide linkages and/or a terminal cap molecule at the 3′-end, the 5′-end, or both of the 3′- and 5′-ends, being present in the same or different strand.

In some embodiments, a polynucleic acid molecule comprises a sense strand and an antisense strand, in which the sense strand comprises about 1 to about 25, for example, about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, or more phosphorothioate internucleotide linkages, and/or one or more (e.g., about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or more) 2′-deoxy, 2′-O-methyl, 2′-deoxy-2′-fluoro, and/or one or more (e.g., about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or more) universal base modified nucleotides, and optionally a terminal cap molecule at the 3-end, the 5′-end, or both of the 3′- and 5′-ends of the sense strand; and in which the antisense strand comprises about 1 to about 25 or more, for example about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, or more phosphorothioate internucleotide linkages, and/or one or more (e.g., about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 or more) 2′-deoxy, 2′-O-methyl, 2′-deoxy-2′-fluoro, and/or one or more (e.g., about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 or more) universal base modified nucleotides, and optionally a terminal cap molecule at the 3′-end, the 5′-end, or both of the 3′- and 5′-ends of the antisense strand. In other embodiments, one or more, for example about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or more, pyrimidine nucleotides of the sense and/or antisense strand are chemically-modified with 2′-deoxy, 2′-O-methyl and/or 2′-deoxy-2′-fluoro nucleotides, with or without about 1 to about 25 or more, for example about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, or more phosphorothioate internucleotide linkages and/or a terminal cap molecule at the 3′-end, the 5′-end, or both of the 3′- and 5′-ends, being present in the same or different strand.

In some embodiments, a polynucleic acid molecule comprises a sense strand and an antisense strand, in which the antisense strand comprises one or more, for example, about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, or more phosphorothioate internucleotide linkages, and/or about one or more (e.g., about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 or more) 2′-deoxy, 2′-O-methyl, 2′-deoxy-2′-fluoro, and/or one or more (e.g., about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 or more) universal base modified nucleotides, and optionally a terminal cap molecule at the 3′-end, the 5′-end, or both of the 3′- and 5′-ends of the sense strand; and wherein the antisense strand comprises about 1 to about 10 or more, specifically about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 or more phosphorothioate internucleotide linkages, and/or one or more (e.g., about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 or more) 2′-deoxy, 2′-O-methyl, 2′-deoxy-2′-fluoro, and/or one or more (e.g., about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 or more) universal base modified nucleotides, and optionally a terminal cap molecule at the 3′-end, the 5′-end, or both of the 3′- and 5′-ends of the antisense strand. In other embodiments, one or more, for example about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, or more pyrimidine nucleotides of the sense and/or antisense strand are chemically-modified with 2′-deoxy, 2′-O-methyl and/or 2′-deoxy-2′-fluoro nucleotides, with or without one or more, for example, about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 or more phosphorothioate internucleotide linkages and/or a terminal cap molecule at the 3′-end, the 5′-end, or both of the 3′ and 5′-ends, being present in the same or different strand.

In some embodiments, a polynucleic acid molecule comprises a sense strand and an antisense strand, in which the antisense strand comprises about 1 to about 25 or more, for example, about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, or more phosphorothioate internucleotide linkages, and/or one or more (e.g., about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 or more) 2′-deoxy, 2′-O-methyl, 2′-deoxy-2′-fluoro, and/or one or more (e.g., about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 or more) universal base modified nucleotides, and optionally a terminal cap molecule at the 3′-end, the 5′-end, or both of the 3′- and 5′-ends of the sense strand; and wherein the antisense strand comprises about 1 to about 25 or more, for example about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, or more phosphorothioate internucleotide linkages, and/or one or more (e.g., about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 or more) 2′-deoxy, 2′-O-methyl, 2′-deoxy-2′-fluoro, and/or one or more (e.g., about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 or more) universal base modified nucleotides, and optionally a terminal cap molecule at the 3′-end, the 5′-end, or both of the 3′- and 5′-ends of the antisense strand. In other embodiments, one or more, for example about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 or more pyrimidine nucleotides of the sense and/or antisense strand are chemically-modified with 2′-deoxy, 2′-O-methyl and/or 2′-deoxy-2′-fluoro nucleotides, with or without about 1 to about 5, for example about 1, 2, 3, 4, 5 or more phosphorothioate internucleotide linkages and/or a terminal cap molecule at the 3′-end, the 5′-end, or both of the 3′- and 5′-ends, being present in the same or different strand.

In some embodiments, a polynucleic acid molecule described herein is a chemically-modified short interfering nucleic acid molecule having about 1 to about 25, for example, about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20 or more phosphorothioate internucleotide linkages in each strand of the polynucleic acid molecule.

In another embodiment, a polynucleic acid molecule described herein comprises 2′-5′ internucleotide linkages. In some instances, the 2′-5′ internucleotide linkage(s) is at the 3′-end, the 5′-end, or both of the 3′- and 5′-ends of one or both sequence strands. In addition instances, the 2′-5′ internucleotide linkage(s) is present at various other positions within one or both sequence strands, for example, about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or more including every internucleotide linkage of a pyrimidine nucleotide in one or both strands of the polynucleic acid molecule comprise a 2′-5′ internucleotide linkage, or about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or more including every internucleotide linkage of a purine nucleotide in one or both strands of the polynucleic acid molecule comprise a 2′-5′ internucleotide linkage.

In some embodiments, a polynucleic acid molecule is a single stranded polynucleic acid molecule that mediates RNAi activity in a cell or reconstituted in vitro system, wherein the polynucleic acid molecule comprises a single stranded polynucleotide having complementarity to a target nucleic acid sequence, and wherein one or more pyrimidine nucleotides present in the polynucleic acid are 2′-deoxy-2′-fluoro pyrimidine nucleotides (e.g., wherein all pyrimidine nucleotides are 2′-deoxy-2′-fluoro pyrimidine nucleotides or alternately a plurality of pyrimidine nucleotides are 2′-deoxy-2′-fluoro pyrimidine nucleotides), and wherein any purine nucleotides present in the polynucleic acid are 2′-deoxy purine nucleotides (e.g., wherein all purine nucleotides are 2′-deoxy purine nucleotides or alternately a plurality of purine nucleotides are 2′-deoxy purine nucleotides), and a terminal cap modification, that is optionally present at the 3′-end, the 5′-end, or both of the 3′ and 5′-ends of the antisense sequence, the polynucleic acid molecule optionally further comprising about 1 to about 4 (e.g., about 1, 2, 3, or 4) terminal 2′-deoxynucleotides at the 3′-end of the polynucleic acid molecule, wherein the terminal nucleotides further comprise one or more (e.g., 1, 2, 3, or 4) phosphorothioate internucleotide linkages, and wherein the polynucleic acid molecule optionally further comprises a terminal phosphate group, such as a 5′-terminal phosphate group.

In some cases, one or more of the artificial nucleotide analogues described herein are resistant toward nucleases such as for example ribonuclease such as RNase H, deoxyribonuclease such as DNase, or exonuclease such as 5′-3′ exonuclease and 3′-5′ exonuclease when compared to natural polynucleic acid molecules. In some instances, artificial nucleotide analogues comprising 2′-O-methyl, 2′-O-methoxyethyl (2′-O-MOE), 2′-O-aminopropyl, 2′-deoxy, T-deoxy-2′-fluoro, 2′-O-aminopropyl (2′-O-AP), 2′-O-dimethylaminoethyl (2′-O-DMAOE), 2′-O-dimethylaminopropyl (2′-O-DMAP), T-O-dimethylaminoethyloxyethyl (2′-O-DMAEOE), or 2′-O—N-methylacetamido (2′-O-NMA) modified, LNA, ENA, PNA, HNA, morpholino, methylphosphonate nucleotides, thiolphosphonate nucleotides, 2′-fluoro N3-P5′-phosphoramidites, or combinations thereof are resistant toward nucleases such as for example ribonuclease such as RNase H, deoxyribonuclease such as DNase, or exonuclease such as 5′-3′ exonuclease and 3′-5′ exonuclease. In some instances, 2′-O-methyl modified polynucleic acid molecule is nuclease resistance (e.g., RNase H, DNase, 5′-3′ exonuclease or 3′-5′ exonuclease resistance). In some instances, 2′O-methoxyethyl (2′-O-MOE) modified polynucleic acid molecule is nuclease resistance (e.g., RNase H, DNase, 5′-3′ exonuclease or 3′-5′ exonuclease resistance). In some instances, 2′-O-aminopropyl modified polynucleic acid molecule is nuclease resistance (e.g., RNase H, DNase, 5′-3′ exonuclease or 3′-5′ exonuclease resistance). In some instances, 2′-deoxy modified polynucleic acid molecule is nuclease resistance (e.g., RNase H, DNase, 5′-3′ exonuclease or 3′-5′ exonuclease resistance). In some instances, T-deoxy-2′-fluoro modified polynucleic acid molecule is nuclease resistance (e.g., RNase H, DNase, 5′-3′ exonuclease or 3′-5′ exonuclease resistance). In some instances, 2′-O-aminopropyl (2′-O-AP) modified polynucleic acid molecule is nuclease resistance (e.g., RNase H, DNase, 5′-3′ exonuclease or 3′-5′ exonuclease resistance). In some instances, 2′-O-dimethylaminoethyl (2′-O-DMAOE) modified polynucleic acid molecule is nuclease resistance (e.g., RNase H, DNase, 5′-3′ exonuclease or 3′-5′ exonuclease resistance). In some instances, 2′-O-dimethylaminopropyl (2′-O-DMAP) modified polynucleic acid molecule is nuclease resistance (e.g., RNase H, DNase, 5′-3′ exonuclease or 3′-5′ exonuclease resistance). In some instances, T-O-dimethylaminoethyloxyethyl (2′-O-DMAEOE) modified polynucleic acid molecule is nuclease resistance (e.g., RNase H, DNase, 5′-3′ exonuclease or 3′-5′ exonuclease resistance). In some instances, 2′-O—N-methylacetamido (2′-O-NMA) modified polynucleic acid molecule is nuclease resistance (e.g., RNase H, DNase, 5′-3′ exonuclease or 3′-5′ exonuclease resistance). In some instances, LNA modified polynucleic acid molecule is nuclease resistance (e.g., RNase H, DNase, 5′-3′ exonuclease or 3′-5′ exonuclease resistance). In some instances, ENA modified polynucleic acid molecule is nuclease resistance (e.g., RNase H, DNase, 5′-3′ exonuclease or 3′-5′ exonuclease resistance). In some instances, HNA modified polynucleic acid molecule is nuclease resistance (e.g., RNase H, DNase, 5′-3′ exonuclease or 3′-5′ exonuclease resistance). In some instances, morpholinos is nuclease resistance (e.g., RNase H, DNase, 5′-3′ exonuclease or 3′-5′ exonuclease resistance). In some instances, PNA modified polynucleic acid molecule is resistant to nucleases (e.g., RNase H, DNase, 5′-3′ exonuclease or 3′-5′ exonuclease resistance). In some instances, methylphosphonate nucleotides modified polynucleic acid molecule is nuclease resistance (e.g., RNase H, DNase, 5′-3′ exonuclease or 3′-5′ exonuclease resistance). In some instances, thiolphosphonate nucleotides modified polynucleic acid molecule is nuclease resistance (e.g., RNase H, DNase, 5′-3′ exonuclease or 3′-5′ exonuclease resistance). In some instances, polynucleic acid molecule comprising 2′-fluoro N3-P5′-phosphoramidites is nuclease resistance (e.g., RNase H, DNase, 5′-3′ exonuclease or 3′-5′ exonuclease resistance). In some instances, the 5′ conjugates described herein inhibit 5′-3′ exonucleolytic cleavage. In some instances, the 3′ conjugates described herein inhibit 3′-5′ exonucleolytic cleavage.

In some embodiments, one or more of the artificial nucleotide analogues described herein have increased binding affinity toward their mRNA target relative to an equivalent natural polynucleic acid molecule. The one or more of the artificial nucleotide analogues comprising 2′-O-methyl, 2′-O-methoxyethyl (2′-O-MOE), 2′-O-aminopropyl, 2′-deoxy, T-deoxy-2′-fluoro, 2′-O-aminopropyl (2′-O-AP), 2′-O-dimethylaminoethyl (2′-O-DMAOE), 2′-O-dimethylaminopropyl (2′-O-DMAP), T-O-dimethylaminoethyloxyethyl (2′-O-DMAEOE), or 2′-O—N-methylacetamido (2′-O-NMA) modified, LNA, ENA, PNA, HNA, morpholino, methylphosphonate nucleotides, thiolphosphonate nucleotides, or 2′-fluoro N3-P5′-phosphoramidites have increased binding affinity toward their mRNA target relative to an equivalent natural polynucleic acid molecule. In some instances, 2′-O-methyl modified polynucleic acid molecule has increased binding affinity toward their mRNA target relative to an equivalent natural polynucleic acid molecule. In some instances, 2′-O-methoxyethyl (2′-O-MOE) modified polynucleic acid molecule has increased binding affinity toward their mRNA target relative to an equivalent natural polynucleic acid molecule. In some instances, 2′-O-aminopropyl modified polynucleic acid molecule has increased binding affinity toward their mRNA target relative to an equivalent natural polynucleic acid molecule. In some instances, 2′-deoxy modified polynucleic acid molecule has increased binding affinity toward their mRNA target relative to an equivalent natural polynucleic acid molecule. In some instances, T-deoxy-2′-fluoro modified polynucleic acid molecule has increased binding affinity toward their mRNA target relative to an equivalent natural polynucleic acid molecule. In some instances, 2′-O-aminopropyl (2′-O-AP) modified polynucleic acid molecule has increased binding affinity toward their mRNA target relative to an equivalent natural polynucleic acid molecule. In some instances, 2′-O-dimethylaminoethyl (2′-O-DMAOE) modified polynucleic acid molecule has increased binding affinity toward their mRNA target relative to an equivalent natural polynucleic acid molecule. In some instances, 2′-O-dimethylaminopropyl (2′-O-DMAP) modified polynucleic acid molecule has increased binding affinity toward their mRNA target relative to an equivalent natural polynucleic acid molecule. In some instances, T-O-dimethylaminoethyloxyethyl (2′-O-DMAEOE) modified polynucleic acid molecule has increased binding affinity toward their mRNA target relative to an equivalent natural polynucleic acid molecule. In some instances, 2′-O—N-methylacetamido (2′-O-NMA) modified polynucleic acid molecule has increased binding affinity toward their mRNA target relative to an equivalent natural polynucleic acid molecule. In some instances, LNA modified polynucleic acid molecule has increased binding affinity toward their mRNA target relative to an equivalent natural polynucleic acid molecule. In some instances, ENA modified polynucleic acid molecule has increased binding affinity toward their mRNA target relative to an equivalent natural polynucleic acid molecule. In some instances, PNA modified polynucleic acid molecule has increased binding affinity toward their mRNA target relative to an equivalent natural polynucleic acid molecule. In some instances, HNA modified polynucleic acid molecule has increased binding affinity toward their mRNA target relative to an equivalent natural polynucleic acid molecule. In some instances, morpholino modified polynucleic acid molecule has increased binding affinity toward their mRNA target relative to an equivalent natural polynucleic acid molecule. In some instances, methylphosphonate nucleotides modified polynucleic acid molecule has increased binding affinity toward their mRNA target relative to an equivalent natural polynucleic acid molecule. In some instances, thiolphosphonate nucleotides modified polynucleic acid molecule has increased binding affinity toward their mRNA target relative to an equivalent natural polynucleic acid molecule. In some instances, polynucleic acid molecule comprising 2′-fluoro N3-P5′-phosphoramidites has increased binding affinity toward their mRNA target relative to an equivalent natural polynucleic acid molecule. In some cases, the increased affinity is illustrated with a lower Kd, a higher melt temperature (Tm), or a combination thereof.

In some embodiments, a polynucleic acid molecule described herein is a chirally pure (or stereo pure) polynucleic acid molecule, or a polynucleic acid molecule comprising a single enantiomer. In some instances, the polynucleic acid molecule comprises L-nucleotide. In some instances, the polynucleic acid molecule comprises D-nucleotides. In some instance, a polynucleic acid molecule composition comprises less than 30%, 25%, 20%, 15%, 10%, 5%, 4%, 3%, 2%, 1%, or less of its mirror enantiomer. In some cases, a polynucleic acid molecule composition comprises less than 30%, 25%, 20%, 15%, 10%, 5%, 4%, 3%, 2%, 1%, or less of a racemic mixture. In some instances, the polynucleic acid molecule is a polynucleic acid molecule described in: U.S. Patent Publication Nos: 2014/194610 and 2015/211006; and PCT Publication No.: WO2015107425.

In some embodiments, a polynucleic acid molecule described herein is further modified to include an aptamer conjugating moiety. In some instances, the aptamer conjugating moiety is a DNA aptamer conjugating moiety. In some instances, the aptamer conjugating moiety is Alphamer (Centauri Therapeutics), which comprises an aptamer portion that recognizes a specific cell-surface target and a portion that presents a specific epitopes for attaching to circulating antibodies. In some instance, a polynucleic acid molecule described herein is further modified to include an aptamer conjugating moiety as described in: U.S. Pat. Nos. 8,604,184, 8,591,910, and 7,850,975.

In additional embodiments, a polynucleic acid molecule described herein is modified to increase its stability. In some embodiment, the polynucleic acid molecule is RNA (e.g., siRNA). In some instances, the polynucleic acid molecule is modified by one or more of the modifications described above to increase its stability. In some cases, the polynucleic acid molecule is modified at the 2′ hydroxyl position, such as by 2′-O-methyl, 2′-O-methoxyethyl (2′-O-MOE), 2′-O-aminopropyl, 2′-deoxy, T-deoxy-2′-fluoro, 2′-O-aminopropyl (2′-O-AP), 2′-O-dimethylaminoethyl (2′-O-DMAOE), 2′-O-dimethylaminopropyl (2′-O-DMAP), T-O-dimethylaminoethyloxyethyl (2′-O-DMAEOE), or 2′-O—N-methylacetamido (2′-O-NMA) modification or by a locked or bridged ribose conformation (e.g., LNA or ENA). In some cases, the polynucleic acid molecule is modified by 2′-O-methyl and/or 2′-O-methoxyethyl ribose. In some cases, the polynucleic acid molecule also includes morpholinos, PNAs, HNA, methylphosphonate nucleotides, thiolphosphonate nucleotides, and/or 2′-fluoro N3-P5′-phosphoramidites to increase its stability. In some instances, the polynucleic acid molecule is a chirally pure (or stereo pure) polynucleic acid molecule. In some instances, the chirally pure (or stereo pure) polynucleic acid molecule is modified to increase its stability. Suitable modifications to the RNA to increase stability for delivery will be apparent to the skilled person.

In some embodiments, a polynucleic acid molecule describe herein has RNAi activity that modulates expression of RNA encoded by a gene involved in a disease or disorder such as, but not limited to, IKBKAP, SMN2, MCAD, LMNA, DMPK, ZNF9, MAPT, FKTN, TDP-43, LDLR, CFTR, DMD, PAH, MSTN, or K-Ras. In some instances, a polynucleic acid molecule describe herein is a double-stranded siRNA molecule that down-regulates expression of at least one of IKBKAP, SMN2, MCAD, LMNA, DMPK, ZNF9, MAPT, FKTN, TDP-43, LDLR, CFTR, DMD, PAH, MSTN, or K-Ras, wherein one of the strands of the double-stranded siRNA molecule comprises a nucleotide sequence that is complementary to a nucleotide sequence of at least one of IKBKAP, SMN2, MCAD, LMNA, DMPK, ZNF9, MAPT, FKTN, TDP-43, LDLR, CFTR, DMD, PAH, MSTN, or K-Ras or RNA encoded by at least one of IKBKAP, SMN2, MCAD, LMNA, DMPK, ZNF9, MAPT, FKTN, TDP-43, LDLR, CFTR, DMD, PAH, MSTN, or K-Ras or a portion thereof, and wherein the second strand of the double-stranded siRNA molecule comprises a nucleotide sequence substantially similar to the nucleotide sequence of at least one of IKBKAP, SMN2, MCAD, LMNA, DMPK, ZNF9, MAPT, FKTN, TDP-43, LDLR, CFTR, DMD, PAH, MSTN, or K-Ras or RNA encoded by at least one of IKBKAP, SMN2, MCAD, LMNA, DMPK, ZNF9, MAPT, FKTN, TDP-43, LDLR, CFTR, DMD, PAH, MSTN, or K-Ras or a portion thereof. In some cases, a polynucleic acid molecule describe herein is a double-stranded siRNA molecule that down-regulates expression of at least one of IKBKAP, SMN2, MCAD, LMNA, DMPK, ZNF9, MAPT, FKTN, TDP-43, LDLR, CFTR, DMD, PAH, MSTN, or K-Ras, wherein each strand of the siRNA molecule comprises about 15 to 25, 18 to 24, or 19 to about 23 nucleotides, and wherein each strand comprises at least about 14, 17, or 19 nucleotides that are complementary to the nucleotides of the other strand. In some cases, a polynucleic acid molecule describe herein is a double-stranded siRNA molecule that down-regulates expression of at least one of IKBKAP, SMN2, MCAD, LMNA, DMPK, ZNF9, MAPT, FKTN, TDP-43, LDLR, CFTR, DMD, PAH, MSTN, or K-Ras, wherein each strand of the siRNA molecule comprises about 19 to about 23 nucleotides, and wherein each strand comprises at least about 19 nucleotides that are complementary to the nucleotides of the other strand. In some instances, the RNAi activity occurs within a cell. In other instances, the RNAi activity occurs in a reconstituted in vitro system.

In some embodiments, a polynucleic acid molecule describe herein has RNAi activity that modulates expression of RNA encoded by a gene involved in muscular dystrophy such as, but not limited to, DMD, DUX4, DYSF, EMD, or LMNA. In some instances, a polynucleic acid molecule describe herein is a double-stranded siRNA molecule that down-regulates expression of at least one of DMD, DUX4, DYSF, EMD, or LMNA, wherein one of the strands of the double-stranded siRNA molecule comprises a nucleotide sequence that is complementary to a nucleotide sequence of at least one of DMD, DUX4, DYSF, EMD, or LMNA or RNA encoded by at least one of DMD, DUX4, DYSF, EMD, or LMNA or a portion thereof, and wherein the second strand of the double-stranded siRNA molecule comprises a nucleotide sequence substantially similar to the nucleotide sequence of at least one of DMD, DUX4, DYSF, EMD, or LMNA or RNA encoded by at least one of DMD, DUX4, DYSF, EMD, or LMNA or a portion thereof. In some cases, a polynucleic acid molecule describe herein is a double-stranded siRNA molecule that down-regulates expression of at least one of DMD, DUX4, DYSF, EMD, or LMNA, wherein each strand of the siRNA molecule comprises about 15 to 25, 18 to 24, or 19 to about 23 nucleotides, and wherein each strand comprises at least about 14, 17, or 19 nucleotides that are complementary to the nucleotides of the other strand. In some cases, a polynucleic acid molecule describe herein is a double-stranded siRNA molecule that down-regulates expression of at least one of DMD, DUX4, DYSF, EMD, or LMNA, wherein each strand of the siRNA molecule comprises about 19 to about 23 nucleotides, and wherein each strand comprises at least about 19 nucleotides that are complementary to the nucleotides of the other strand. In some instances, the RNAi activity occurs within a cell. In other instances, the RNAi activity occurs in a reconstituted in vitro system.

In some embodiments, a polynucleic acid molecule describe herein has RNAi activity that modulates expression of RNA encoded by the DMD gene. In some instances, a polynucleic acid molecule describe herein is a single-stranded siRNA molecule that down-regulates expression of DMD, wherein the single-stranded siRNA molecule comprises a nucleotide sequence that is complementary to a nucleotide sequence of DMD or RNA encoded by DMD or a portion thereof. In some cases, a polynucleic acid molecule describe herein is a single-stranded siRNA molecule that down-regulates expression of DMD, wherein the siRNA molecule comprises about 15 to 25, 18 to 24, or 19 to about 23 nucleotides. In some cases, a polynucleic acid molecule describe herein is a single-stranded siRNA molecule that down-regulates expression of DMD, wherein the siRNA molecule comprises about 19 to about 23 nucleotides. In some instances, the RNAi activity occurs within a cell. In other instances, the RNAi activity occurs in a reconstituted in vitro system.

In some instances, the polynucleic acid molecule is a double-stranded polynucleotide molecule comprising self-complementary sense and antisense regions, wherein the antisense region comprises nucleotide sequence that is complementary to nucleotide sequence in a target nucleic acid molecule or a portion thereof and the sense region having nucleotide sequence corresponding to the target nucleic acid sequence or a portion thereof. In some instances, the polynucleic acid molecule is assembled from two separate polynucleotides, where one strand is the sense strand and the other is the antisense strand, wherein the antisense and sense strands are self-complementary (e.g., each strand comprises nucleotide sequence that is complementary to nucleotide sequence in the other strand; such as where the antisense strand and sense strand form a duplex or double stranded structure, for example wherein the double stranded region is about 19, 20, 21, 22, 23, or more base pairs); the antisense strand comprises nucleotide sequence that is complementary to nucleotide sequence in a target nucleic acid molecule or a portion thereof and the sense strand comprises nucleotide sequence corresponding to the target nucleic acid sequence or a portion thereof. Alternatively, the polynucleic acid molecule is assembled from a single oligonucleotide, where the self-complementary sense and antisense regions of the polynucleic acid molecule are linked by means of a nucleic acid based or non-nucleic acid-based linker(s).

In some cases, the polynucleic acid molecule is a polynucleotide with a duplex, asymmetric duplex, hairpin or asymmetric hairpin secondary structure, having self-complementary sense and antisense regions, wherein the antisense region comprises nucleotide sequence that is complementary to nucleotide sequence in a separate target nucleic acid molecule or a portion thereof and the sense region having nucleotide sequence corresponding to the target nucleic acid sequence or a portion thereof. In other cases, the polynucleic acid molecule is a circular single-stranded polynucleotide having two or more loop structures and a stem comprising self-complementary sense and antisense regions, wherein the antisense region comprises nucleotide sequence that is complementary to nucleotide sequence in a target nucleic acid molecule or a portion thereof and the sense region having nucleotide sequence corresponding to the target nucleic acid sequence or a portion thereof, and wherein the circular polynucleotide is processed either in vivo or in vitro to generate an active polynucleic acid molecule capable of mediating RNAi. In additional cases, the polynucleic acid molecule also comprises a single stranded polynucleotide having nucleotide sequence complementary to nucleotide sequence in a target nucleic acid molecule or a portion thereof (for example, where such polynucleic acid molecule does not require the presence within the polynucleic acid molecule of nucleotide sequence corresponding to the target nucleic acid sequence or a portion thereof), wherein the single stranded polynucleotide further comprises a terminal phosphate group, such as a 5′-phosphate (see for example Martinez et al., 2002, Cell., 110, 563-574 and Schwarz et al., 2002, Molecular Cell, 10, 537-568), or 5′,3′-diphosphate.

In some instances, an asymmetric is a linear polynucleic acid molecule comprising an antisense region, a loop portion that comprises nucleotides or non-nucleotides, and a sense region that comprises fewer nucleotides than the antisense region to the extent that the sense region has enough complimentary nucleotides to base pair with the antisense region and form a duplex with loop. For example, an asymmetric hairpin polynucleic acid molecule comprises an antisense region having length sufficient to mediate RNAi in a cell or in vitro system (e.g. about 19 to about 22 nucleotides) and a loop region comprising about 4 to about 8 nucleotides, and a sense region having about 3 to about 18 nucleotides that are complementary to the antisense region. In some cases, the asymmetric hairpin polynucleic acid molecule also comprises a 5′-terminal phosphate group that is chemically modified. In additional cases, the loop portion of the asymmetric hairpin polynucleic acid molecule comprises nucleotides, non-nucleotides, linker molecules, or conjugate molecules.

In some embodiments, an asymmetric duplex is a polynucleic acid molecule having two separate strands comprising a sense region and an antisense region, wherein the sense region comprises fewer nucleotides than the antisense region to the extent that the sense region has enough complimentary nucleotides to base pair with the antisense region and form a duplex. For example, an asymmetric duplex polynucleic acid molecule comprises an antisense region having length sufficient to mediate RNAi in a cell or in vitro system (e.g. about 19 to about 22 nucleotides) and a sense region having about 3 to about 18 nucleotides that are complementary to the antisense region.

In some cases, an universal base refers to nucleotide base analogs that form base pairs with each of the natural DNA/RNA bases with little discrimination between them. Non-limiting examples of universal bases include C-phenyl, C-naphthyl and other aromatic derivatives, inosine, azole carboxamides, and nitroazole derivatives such as 3-nitropyrrole, 4-nitroindole, 5-nitroindole, and 6-nitroindole as known in the art (see for example Loakes, 2001, Nucleic Acids Research, 29, 2437-2447).

Polynucleic Acid Molecule Synthesis

In some embodiments, a polynucleic acid molecule described herein is constructed using chemical synthesis and/or enzymatic ligation reactions using procedures known in the art. For example, a polynucleic acid molecule is chemically synthesized using naturally occurring nucleotides or variously modified nucleotides designed to increase the biological stability of the molecules or to increase the physical stability of the duplex formed between the polynucleic acid molecule and target nucleic acids. Exemplary methods include those described in: U.S. Pat. Nos. 5,142,047; 5,185,444; 5,889,136; 6,008,400; and 6,111,086; PCT Publication No. WO2009099942; or European Publication No. 1579015. Additional exemplary methods include those described in: Griffey et al., “2′-O-aminopropyl ribonucleotides: a zwitterionic modification that enhances the exonuclease resistance and biological activity of antisense oligonucleotides,” J. Med. Chem. 39(26):5100-5109 (1997)); Obika, et al. “Synthesis of 2′-0,4′-C-methyleneuridine and -cytidine. Novel bicyclic nucleosides having a fixed C3, -endo sugar puckering”. Tetrahedron Letters 38 (50): 8735 (1997); Koizumi, M. “ENA oligonucleotides as therapeutics”. Current opinion in molecular therapeutics 8 (2): 144-149 (2006); and Abramova et al., “Novel oligonucleotide analogues based on morpholino nucleoside subunits-antisense technologies: new chemical possibilities,” Indian Journal of Chemistry 48B:1721-1726 (2009). Alternatively, the polynucleic acid molecule is produced biologically using an expression vector into which a polynucleic acid molecule has been subcloned in an antisense orientation (i.e., RNA transcribed from the inserted polynucleic acid molecule will be of an antisense orientation to a target polynucleic acid molecule of interest).

In some embodiments, a polynucleic acid molecule is synthesized via a tandem synthesis methodology, wherein both strands are synthesized as a single contiguous oligonucleotide fragment or strand separated by a cleavable linker which is subsequently cleaved to provide separate fragments or strands that hybridize and permit purification of the duplex.

In some instances, a polynucleic acid molecule is also assembled from two distinct nucleic acid strands or fragments wherein one fragment includes the sense region and the second fragment includes the antisense region of the molecule.

Additional modification methods for incorporating, for example, sugar, base and phosphate modifications include: Eckstein et al., International Publication PCT No. WO 92/07065; Perrault et al. Nature, 1990, 344, 565-568; Pieken et al. Science, 1991, 253, 314-317; Usman and Cedergren, Trends in Biochem. Sci., 1992, 17, 334-339; Usman et al. International Publication PCT No. WO 93/15187; Sproat, U.S. Pat. No. 5,334,711 and Beigelman et al., 1995, J. Biol. Chem., 270, 25702; Beigelman et al., International PCT publication No. WO 97/26270; Beigelman et al., U.S. Pat. No. 5,716,824; Usman et al., U.S. Pat. No. 5,627,053; Woolf et al., International PCT Publication No. WO 98/13526; Thompson et al., U.S. Ser. No. 60/082,404 which was filed on Apr. 20, 1998; Karpeisky et al., 1998, Tetrahedron Lett., 39, 1131; Earnshaw and Gait, 1998, Biopolymers (Nucleic Acid Sciences), 48, 39-55; Verma and Eckstein, 1998, Annu. Rev. Biochem., 67, 99-134; and Burlina et al., 1997, Bioorg. Med. Chem., 5, 1999-2010. Such publications describe general methods and strategies to determine the location of incorporation of sugar, base and/or phosphate modifications and the like into nucleic acid molecules without modulating catalysis.

In some instances, while chemical modification of the polynucleic acid molecule internucleotide linkages with phosphorothioate, phosphorodithioate, and/or 5′-methylphosphonate linkages improves stability, excessive modifications sometimes cause toxicity or decreased activity. Therefore, when designing nucleic acid molecules, the amount of these internucleotide linkages in some cases is minimized. In such cases, the reduction in the concentration of these linkages lowers toxicity, increases efficacy and higher specificity of these molecules.

Nucleic Acid-Polypeptide Conjugate

In some embodiments, a polynucleic acid molecule is further conjugated to a polypeptide A for delivery to a site of interest. In some cases, a polynucleic acid molecule is conjugated to a polypeptide A and optionally a polymeric moiety.

In some instances, at least one polypeptide A is conjugated to at least one B. In some instances, the at least one polypeptide A is conjugated to the at least one B to form an A-B conjugate. In some embodiments, at least one A is conjugated to the 5′ terminus of B, the 3′ terminus of B, an internal site on B, or in any combinations thereof. In some instances, the at least one polypeptide A is conjugated to at least two B. In some instances, the at least one polypeptide A is conjugated to at least 2, 3, 4, 5, 6, 7, 8, or more B.

In some embodiments, at least one polypeptide A is conjugated at one terminus of at least one B while at least one C is conjugated at the opposite terminus of the at least one B to form an A-B-C conjugate. In some instances, at least one polypeptide A is conjugated at one terminus of the at least one B while at least one of C is conjugated at an internal site on the at least one B. In some instances, at least one polypeptide A is conjugated directly to the at least one C. In some instances, the at least one B is conjugated indirectly to the at least one polypeptide A via the at least one C to form an A-C-B conjugate.

In some instances, at least one B and/or at least one C, and optionally at least one D are conjugated to at least one polypeptide A. In some instances, the at least one B is conjugated at a terminus (e.g., a 5′ terminus or a 3′ terminus) to the at least one polypeptide A or are conjugated via an internal site to the at least one polypeptide A. In some cases, the at least one C is conjugated either directly to the at least one polypeptide A or indirectly via the at least one B. If indirectly via the at least one B, the at least one C is conjugated either at the same terminus as the at least one polypeptide A on B, at opposing terminus from the at least one polypeptide A, or independently at an internal site. In some instances, at least one additional polypeptide A is further conjugated to the at least one polypeptide A, to B, or to C. In additional instances, the at least one D is optionally conjugated either directly or indirectly to the at least one polypeptide A, to the at least one B, or to the at least one C. If directly to the at least one polypeptide A, the at least one D is also optionally conjugated to the at least one B to form an A-D-B conjugate or is optionally conjugated to the at least one B and the at least one C to form an A-D-B-C conjugate. In some instances, the at least one D is directly conjugated to the at least one polypeptide A and indirectly to the at least one B and the at least one C to form a D-A-B-C conjugate. If indirectly to the at least one polypeptide A, the at least one D is also optionally conjugated to the at least one B to form an A-B-D conjugate or is optionally conjugated to the at least one B and the at least one C to form an A-B-D-C conjugate. In some instances, at least one additional D is further conjugated to the at least one polypeptide A, to B, or to C.

In some embodiments, a polynucleic acid molecule conjugate comprises a construct as illustrated in FIG. 19A.

In some embodiments, a polynucleic acid molecule conjugate comprises a construct as illustrated in FIG. 19B.

In some embodiments, a polynucleic acid molecule conjugate comprises a construct as illustrated in FIG. 19C.

In some embodiments, a polynucleic acid molecule conjugate comprises a construct as illustrated in FIG. 19D.

In some embodiments, a polynucleic acid molecule conjugate comprises a construct as illustrated in FIG. 19E.

In some embodiments, a polynucleic acid molecule conjugate comprises a construct as illustrated in FIG. 19F.

In some embodiments, a polynucleic acid molecule conjugate comprises a construct as illustrated in FIG. 19G.

In some embodiments, a polynucleic acid molecule conjugate comprises a construct as illustrated in FIG. 19H.

In some embodiments, a polynucleic acid molecule conjugate comprises a construct as illustrated in FIG. 19I.

In some embodiments, a polynucleic acid molecule conjugate comprises a construct as illustrated in FIG. 19J.

In some embodiments, a polynucleic acid molecule conjugate comprises a construct as illustrated in FIG. 19K.

In some embodiments, a polynucleic acid molecule conjugate comprises a construct as illustrated in FIG. 19L.

The antibody as illustrated above is for representation purposes only and encompasses a humanized antibody or binding fragment thereof, chimeric antibody or binding fragment thereof, monoclonal antibody or binding fragment thereof, monovalent Fab′, divalent Fab2, single-chain variable fragment (scFv), diabody, minibody, nanobody, single-domain antibody (sdAb), or camelid antibody or binding fragment thereof.

Binding Moiety

In some embodiments, the binding moiety A is a polypeptide. In some instances, the polypeptide is an antibody or its fragment thereof. In some cases, the fragment is a binding fragment. In some instances, the antibody or binding fragment thereof comprises a humanized antibody or binding fragment thereof, murine antibody or binding fragment thereof, chimeric antibody or binding fragment thereof, monoclonal antibody or binding fragment thereof, monovalent Fab′, divalent Fab₂, F(ab)′₃ fragments, single-chain variable fragment (scFv), bis-scFv, (scFv)₂, diabody, minibody, nanobody, triabody, tetrabody, disulfide stabilized Fv protein (dsFv), single-domain antibody (sdAb), Ig NAR, camelid antibody or binding fragment thereof, bispecific antibody or biding fragment thereof, or a chemically modified derivative thereof.

In some instances, A is an antibody or binding fragment thereof. In some instances, A is a humanized antibody or binding fragment thereof, murine antibody or binding fragment thereof, chimeric antibody or binding fragment thereof, monoclonal antibody or binding fragment thereof, monovalent Fab′, divalent Fab₂, F(ab)′₃ fragments, single-chain variable fragment (scFv), bis-scFv, (scFv)₂, diabody, minibody, nanobody, triabody, tetrabody, disulfide stabilized Fv protein (“dsFv”), single-domain antibody (sdAb), Ig NAR, camelid antibody or binding fragment thereof, bispecific antibody or biding fragment thereof, or a chemically modified derivative thereof. In some instances, A is a humanized antibody or binding fragment thereof. In some instances, A is a murine antibody or binding fragment thereof. In some instances, A is a chimeric antibody or binding fragment thereof. In some instances, A is a monoclonal antibody or binding fragment thereof. In some instances, A is a monovalent Fab′. In some instances, A is a diavalent Fab₂. In some instances, A is a single-chain variable fragment (scFv).

In some embodiments, the binding moiety A is a bispecific antibody or binding fragment thereof. In some instances, the bispecific antibody is a trifunctional antibody or a bispecific mini-antibody. In some cases, the bispecific antibody is a trifunctional antibody. In some instances, the trifunctional antibody is a full length monoclonal antibody comprising binding sites for two different antigens.

In some cases, the bispecific antibody is a bispecific mini-antibody. In some instances, the bispecific mini-antibody comprises divalent Fab₂, F(ab)′₃ fragments, bis-scFv, (scFv)₂, diabody, minibody, triabody, tetrabody or a bi-specific T-cell engager (BiTE). In some embodiments, the bi-specific T-cell engager is a fusion protein that contains two single-chain variable fragments (scFvs) in which the two scFvs target epitopes of two different antigens.

In some embodiments, the binding moiety A is a bispecific mini-antibody. In some instances, A is a bispecific Fab₂. In some instances, A is a bispecific F(ab)′₃ fragment. In some cases, A is a bispecific bis-scFv. In some cases, A is a bispecific (scFv)₂. In some embodiments, A is a bispecific diabody. In some embodiments, A is a bispecific minibody. In some embodiments, A is a bispecific triabody. In other embodiments, A is a bispecific tetrabody. In other embodiments, A is a bi-specific T-cell engager (BiTE).

In some embodiments, the binding moiety A is a trispecific antibody. In some instances, the trispecific antibody comprises F(ab)′₃ fragments or a triabody. In some instances, A is a trispecific F(ab)′₃ fragment. In some cases, A is a triabody. In some embodiments, A is a trispecific antibody as described in Dimas, et al., “Development of a trispecific antibody designed to simultaneously and efficiently target three different antigens on tumor cells,” Mol. Pharmaceutics, 12(9): 3490-3501 (2015).

In some embodiments, the binding moiety A is an antibody or binding fragment thereof that recognizes a cell surface protein. In some instances, the binding moiety A is an antibody or binding fragment thereof that recognizes a cell surface protein on a muscle cell. Exemplary cell surface proteins recognized by an antibody or binding fragment thereof include, but are not limited to, Sca-1, CD34, Myo-D, myogenin, MRF4, NCAM, CD43, and CD95 (Fas).

In some instances, the cell surface protein comprises clusters of differentiation (CD) cell surface markers. Exemplary CD cell surface markers include, but are not limited to, CD1, CD2, CD3, CD4, CD5, CD6, CD7, CD8, CD9, CD10, CD11a, CD11b, CD11c, CD11d, CDw12, CD13, CD14, CD15, CD15s, CD16, CDw17, CD18, CD19, CD20, CD21, CD22, CD23, CD24, CD25, CD26, CD27, CD28, CD29, CD30, CD31, CD32, CD33, CD34, CD35, CD36, CD37, CD38, CD39, CD40, CD41, CD42, CD43, CD44, CD45, CD45RO, CD45RA, CD45RB, CD46, CD47, CD48, CD49a, CD49b, CD49c, CD49d, CD49e, CD49f, CD50, CD51, CD52, CD53, CD54, CD55, CD56, CD57, CD58, CD59, CDw60, CD61, CD62E, CD62L (L-selectin), CD62P, CD63, CD64, CD65, CD66a, CD66b, CD66c, CD66d, CD66e, CD79 (e.g., CD79a, CD79b), CD90, CD95 (Fas), CD103, CD104, CD125 (IL5RA), CD134 (OX40), CD137 (4-1BB), CD152 (CTLA-4), CD221, CD274, CD279 (PD-1), CD319 (SLAMF7), CD326 (EpCAM), and the like.

In some instances, the binding moiety A is an antibody or binding fragment thereof that recognizes a CD cell surface marker. In some instances, the binding moiety A is an antibody or binding fragment thereof that recognizes CD1, CD2, CD3, CD4, CD5, CD6, CD7, CD8, CD9, CD10, CD11a, CD11b, CD11c, CD11d, CDw12, CD13, CD14, CD15, CD15s, CD16, CDw17, CD18, CD19, CD20, CD21, CD22, CD23, CD24, CD25, CD26, CD27, CD28, CD29, CD30, CD31, CD32, CD33, CD34, CD35, CD36, CD37, CD38, CD39, CD40, CD41, CD42, CD43, CD44, CD45, CD45RO, CD45RA, CD45RB, CD46, CD47, CD48, CD49a, CD49b, CD49c, CD49d, CD49e, CD49f, CD50, CD51, CD52, CD53, CD54, CD55, CD56, CD57, CD58, CD59, CDw60, CD61, CD62E, CD62L (L-selectin), CD62P, CD63, CD64, CD65, CD66a, CD66b, CD66c, CD66d, CD66e, CD79 (e.g., CD79a, CD79b), CD90, CD95 (Fas), CD103, CD104, CD125 (IL5RA), CD134 (OX40), CD137 (4-1BB), CD152 (CTLA-4), CD221, CD274, CD279 (PD-1), CD319 (SLAMF7), CD326 (EpCAM), or a combination thereof.

In some embodiments, the binding moiety A is conjugated to a polynucleic acid molecule (B) non-specifically. In some instances, the binding moiety A is conjugated to a polynucleic acid molecule (B) via a lysine residue or a cysteine residue, in a non-site specific manner. In some instances, the binding moiety A is conjugated to a polynucleic acid molecule (B) via a lysine residue in a non-site specific manner. In some cases, the binding moiety A is conjugated to a polynucleic acid molecule (B) via a cysteine residue in a non-site specific manner.

In some embodiments, the binding moiety A is conjugated to a polynucleic acid molecule (B) in a site-specific manner. In some instances, the binding moiety A is conjugated to a polynucleic acid molecule (B) through a lysine residue, a cysteine residue, at the 5′-terminus, at the 3′-terminus, an unnatural amino acid, or an enzyme-modified or enzyme-catalyzed residue, via a site-specific manner. In some instances, the binding moiety A is conjugated to a polynucleic acid molecule (B) through a lysine residue via a site-specific manner. In some instances, the binding moiety A is conjugated to a polynucleic acid molecule (B) through a cysteine residue via a site-specific manner. In some instances, the binding moiety A is conjugated to a polynucleic acid molecule (B) at the 5′-terminus via a site-specific manner. In some instances, the binding moiety A is conjugated to a polynucleic acid molecule (B) at the 3′-terminus via a site-specific manner. In some instances, the binding moiety A is conjugated to a polynucleic acid molecule (B) through an unnatural amino acid via a site-specific manner. In some instances, the binding moiety A is conjugated to a polynucleic acid molecule (B) through an enzyme-modified or enzyme-catalyzed residue via a site-specific manner.

In some embodiments, one or more polynucleic acid molecule (B) is conjugated to a binding moiety A. In some instances, about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, or more polynucleic acid molecules are conjugated to one binding moiety A. In some instances, about 1 polynucleic acid molecule is conjugated to one binding moiety A. In some instances, about 2 polynucleic acid molecules are conjugated to one binding moiety A. In some instances, about 3 polynucleic acid molecules are conjugated to one binding moiety A. In some instances, about 4 polynucleic acid molecules are conjugated to one binding moiety A. In some instances, about 5 polynucleic acid molecules are conjugated to one binding moiety A. In some instances, about 6 polynucleic acid molecules are conjugated to one binding moiety A. In some instances, about 7 polynucleic acid molecules are conjugated to one binding moiety A. In some instances, about 8 polynucleic acid molecules are conjugated to one binding moiety A. In some instances, about 9 polynucleic acid molecules are conjugated to one binding moiety A. In some instances, about 10 polynucleic acid molecules are conjugated to one binding moiety A. In some instances, about 11 polynucleic acid molecules are conjugated to one binding moiety A. In some instances, about 12 polynucleic acid molecules are conjugated to one binding moiety A. In some instances, about 13 polynucleic acid molecules are conjugated to one binding moiety A. In some instances, about 14 polynucleic acid molecules are conjugated to one binding moiety A. In some instances, about 15 polynucleic acid molecules are conjugated to one binding moiety A. In some instances, about 16 polynucleic acid molecules are conjugated to one binding moiety A. In some cases, the one or more polynucleic acid molecules are the same. In other cases, the one or more polynucleic acid molecules are different.

In some embodiments, the number of polynucleic acid molecule (B) conjugated to a binding moiety A forms a ratio. In some instances, the ratio is referred to as a DAR (drug-to-antibody) ratio, in which the drug as referred to herein is the polynucleic acid molecule (B). In some instances, the DAR ratio of the polynucleic acid molecule (B) to binding moiety A is about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, or greater. In some instances, the DAR ratio of the polynucleic acid molecule (B) to binding moiety A is about 1 or greater. In some instances, the DAR ratio of the polynucleic acid molecule (B) to binding moiety A is about 2 or greater. In some instances, the DAR ratio of the polynucleic acid molecule (B) to binding moiety A is about 3 or greater. In some instances, the DAR ratio of the polynucleic acid molecule (B) to binding moiety A is about 4 or greater. In some instances, the DAR ratio of the polynucleic acid molecule (B) to binding moiety A is about 5 or greater. In some instances, the DAR ratio of the polynucleic acid molecule (B) to binding moiety A is about 6 or greater. In some instances, the DAR ratio of the polynucleic acid molecule (B) to binding moiety A is about 7 or greater. In some instances, the DAR ratio of the polynucleic acid molecule (B) to binding moiety A is about 8 or greater. In some instances, the DAR ratio of the polynucleic acid molecule (B) to binding moiety A is about 9 or greater. In some instances, the DAR ratio of the polynucleic acid molecule (B) to binding moiety A is about 10 or greater. In some instances, the DAR ratio of the polynucleic acid molecule (B) to binding moiety A is about 11 or greater. In some instances, the DAR ratio of the polynucleic acid molecule (B) to binding moiety A is about 12 or greater.

In some instances, the DAR ratio of the polynucleic acid molecule (B) to binding moiety A is about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, or 16. In some instances, the DAR ratio of the polynucleic acid molecule (B) to binding moiety A is about 1. In some instances, the DAR ratio of the polynucleic acid molecule (B) to binding moiety A is about 2. In some instances, the DAR ratio of the polynucleic acid molecule (B) to binding moiety A is about 3. In some instances, the DAR ratio of the polynucleic acid molecule (B) to binding moiety A is about 4. In some instances, the DAR ratio of the polynucleic acid molecule (B) to binding moiety A is about 5. In some instances, the DAR ratio of the polynucleic acid molecule (B) to binding moiety A is about 6. In some instances, the DAR ratio of the polynucleic acid molecule (B) to binding moiety A is about 7. In some instances, the DAR ratio of the polynucleic acid molecule (B) to binding moiety A is about 8. In some instances, the DAR ratio of the polynucleic acid molecule (B) to binding moiety A is about 9. In some instances, the DAR ratio of the polynucleic acid molecule (B) to binding moiety A is about 10. In some instances, the DAR ratio of the polynucleic acid molecule (B) to binding moiety A is about 11. In some instances, the DAR ratio of the polynucleic acid molecule (B) to binding moiety A is about 12. In some instances, the DAR ratio of the polynucleic acid molecule (B) to binding moiety A is about 13. In some instances, the DAR ratio of the polynucleic acid molecule (B) to binding moiety A is about 14. In some instances, the DAR ratio of the polynucleic acid molecule (B) to binding moiety A is about 15. In some instances, the DAR ratio of the polynucleic acid molecule (B) to binding moiety A is about 16.

In some instances, the DAR ratio of the polynucleic acid molecule (B) to binding moiety A is 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, or 16. In some instances, the DAR ratio of the polynucleic acid molecule (B) to binding moiety A is 1. In some instances, the DAR ratio of the polynucleic acid molecule (B) to binding moiety A is 2. In some instances, the DAR ratio of the polynucleic acid molecule (B) to binding moiety A is 4. In some instances, the DAR ratio of the polynucleic acid molecule (B) to binding moiety A is 6. In some instances, the DAR ratio of the polynucleic acid molecule (B) to binding moiety A is 8. In some instances, the DAR ratio of the polynucleic acid molecule (B) to binding moiety A is 12.

In some instances, a conjugate comprising polynucleic acid molecule (B) and binding moiety A has improved activity as compared to a conjugate comprising polynucleic acid molecule (B) without a binding moiety A. In some instances, improved activity results in enhanced biologically relevant functions, e.g., improved stability, affinity, binding, functional activity, and efficacy in treatment or prevention of a disease state. In some instances, the disease state is a result of one or more mutated exons of a gene. In some instances, the conjugate comprising polynucleic acid molecule (B) and binding moiety A results in increased exon skipping of the one or more mutated exons as compared to the conjugate comprising polynucleic acid molecule (B) without a binding moiety A. In some instances, exon skipping is increased by at least or about 5%, 10%, 20%, 25%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 95%, or more than 95% in the conjugate comprising polynucleic acid molecule (B) and binding moiety A as compared to the conjugate comprising polynucleic acid molecule (B) without a binding moiety A.

In some embodiments, an antibody or its binding fragment is further modified using conventional techniques known in the art, for example, by using amino acid deletion, insertion, substitution, addition, and/or by recombination and/or any other modification (e.g. posttranslational and chemical modifications, such as glycosylation and phosphorylation) known in the art either alone or in combination. In some instances, the modification further comprises a modification for modulating interaction with Fc receptors. In some instances, the one or more modifications include those described in, for example, International Publication No. WO97/34631, which discloses amino acid residues involved in the interaction between the Fc domain and the FcRn receptor. Methods for introducing such modifications in the nucleic acid sequence underlying the amino acid sequence of an antibody or its binding fragment is well known to the person skilled in the art.

In some instances, an antibody binding fragment further encompasses its derivatives and includes polypeptide sequences containing at least one CDR.

In some instances, the term “single-chain” as used herein means that the first and second domains of a bi-specific single chain construct are covalently linked, preferably in the form of a co-linear amino acid sequence encodable by a single nucleic acid molecule.

In some instances, a bispecific single chain antibody construct relates to a construct comprising two antibody derived binding domains. In such embodiments, bi-specific single chain antibody construct is tandem bi-scFv or diabody. In some instances, a scFv contains a VH and VL domain connected by a linker peptide. In some instances, linkers are of a length and sequence sufficient to ensure that each of the first and second domains can, independently from one another, retain their differential binding specificities.

In some embodiments, binding to or interacting with as used herein defines a binding/interaction of at least two antigen-interaction-sites with each other. In some instances, antigen-interaction-site defines a motif of a polypeptide that shows the capacity of specific interaction with a specific antigen or a specific group of antigens. In some cases, the binding/interaction is also understood to define a specific recognition. In such cases, specific recognition refers to that the antibody or its binding fragment is capable of specifically interacting with and/or binding to at least two amino acids of each of a target molecule. For example, specific recognition relates to the specificity of the antibody molecule, or to its ability to discriminate between the specific regions of a target molecule. In additional instances, the specific interaction of the antigen-interaction-site with its specific antigen results in an initiation of a signal, e.g. due to the induction of a change of the conformation of the antigen, an oligomerization of the antigen, etc. In further embodiments, the binding is exemplified by the specificity of a “key-lock-principle”. Thus in some instances, specific motifs in the amino acid sequence of the antigen-interaction-site and the antigen bind to each other as a result of their primary, secondary or tertiary structure as well as the result of secondary modifications of said structure. In such cases, the specific interaction of the antigen-interaction-site with its specific antigen results as well in a simple binding of the site to the antigen.

In some instances, specific interaction further refers to a reduced cross-reactivity of the antibody or its binding fragment or a reduced off-target effect. For example, the antibody or its binding fragment that bind to the polypeptide/protein of interest but do not or do not essentially bind to any of the other polypeptides are considered as specific for the polypeptide/protein of interest. Examples for the specific interaction of an antigen-interaction-site with a specific antigen comprise the specificity of a ligand for its receptor, for example, the interaction of an antigenic determinant (epitope) with the antigenic binding site of an antibody.

Conjugation Chemistry

In some embodiments, a polynucleic acid molecule B is conjugated to a binding moiety. In some instances, the binding moiety comprises amino acids, peptides, polypeptides, proteins, antibodies, antigens, toxins, hormones, lipids, nucleotides, nucleosides, sugars, carbohydrates, polymers such as polyethylene glycol and polypropylene glycol, as well as analogs or derivatives of all of these classes of substances. Additional examples of binding moiety also include steroids, such as cholesterol, phospholipids, di- and triacylglycerols, fatty acids, hydrocarbons (e.g., saturated, unsaturated, or contains substitutions), enzyme substrates, biotin, digoxigenin, and polysaccharides. In some instances, the binding moiety is an antibody or binding fragment thereof. In some instances, the polynucleic acid molecule is further conjugated to a polymer, and optionally an endosomolytic moiety.

In some embodiments, the polynucleic acid molecule is conjugated to the binding moiety by a chemical ligation process. In some instances, the polynucleic acid molecule is conjugated to the binding moiety by a native ligation. In some instances, the conjugation is as described in: Dawson, et al. “Synthesis of proteins by native chemical ligation,” Science 1994, 266, 776-779; Dawson, et al. “Modulation of Reactivity in Native Chemical Ligation through the Use of Thiol Additives,” J. Am. Chem. Soc. 1997, 119, 4325-4329; Hackeng, et al. “Protein synthesis by native chemical ligation: Expanded scope by using straightforward methodology.,” Proc. Natl. Acad. Sci. USA 1999, 96, 10068-10073; or Wu, et al. “Building complex glycopeptides: Development of a cysteine-free native chemical ligation protocol,” Angew. Chem. Int. Ed. 2006, 45, 4116-4125. In some instances, the conjugation is as described in U.S. Pat. No. 8,936,910. In some embodiments, the polynucleic acid molecule is conjugated to the binding moiety either site-specifically or non-specifically via native ligation chemistry.

In some instances, the polynucleic acid molecule is conjugated to the binding moiety by a site-directed method utilizing a “traceless” coupling technology (Philochem). In some instances, the “traceless” coupling technology utilizes an N-terminal 1,2-aminothiol group on the binding moiety which is then conjugate with a polynucleic acid molecule containing an aldehyde group. (see Casi et al., “Site-specific traceless coupling of potent cytotoxic drugs to recombinant antibodies for pharmacodelivery,”JACS 134(13): 5887-5892 (2012))

In some instances, the polynucleic acid molecule is conjugated to the binding moiety by a site-directed method utilizing an unnatural amino acid incorporated into the binding moiety. In some instances, the unnatural amino acid comprises p-acetylphenylalanine (pAcPhe). In some instances, the keto group of pAcPhe is selectively coupled to an alkoxy-amine derivatived conjugating moiety to form an oxime bond. (see Axup et al., “Synthesis of site-specific antibody-drug conjugates using unnatural amino acids,” PNAS 109(40): 16101-16106 (2012)).

In some instances, the polynucleic acid molecule is conjugated to the binding moiety by a site-directed method utilizing an enzyme-catalyzed process. In some instances, the site-directed method utilizes SMARTag™ technology (Redwood). In some instances, the SMARTag™ technology comprises generation of a formylglycine (FGly) residue from cysteine by formylglycine-generating enzyme (FGE) through an oxidation process under the presence of an aldehyde tag and the subsequent conjugation of FGly to an alkylhydraine-functionalized polynucleic acid molecule via hydrazino-Pictet-Spengler (HIPS) ligation. (see Wu et al., “Site-specific chemical modification of recombinant proteins produced in mammalian cells by using the genetically encoded aldehyde tag,” PNAS 106(9): 3000-3005 (2009); Agarwal, et al., “A Pictet-Spengler ligation for protein chemical modification,” PNAS 110(1): 46-51 (2013))

In some instances, the enzyme-catalyzed process comprises microbial transglutaminase (mTG). In some cases, the polynucleic acid molecule is conjugated to the binding moiety utilizing a microbial transglutaminze catalyzed process. In some instances, mTG catalyzes the formation of a covalent bond between the amide side chain of a glutamine within the recognition sequence and a primary amine of a functionalized polynucleic acid molecule. In some instances, mTG is produced from Streptomyces mobarensis. (see Strop et al., “Location matters: site of conjugation modulates stability and pharmacokinetics of antibody drug conjugates,” Chemistry and Biology 20(2) 161-167 (2013))

In some instances, the polynucleic acid molecule is conjugated to the binding moiety by a method as described in PCT Publication No. WO2014/140317, which utilizes a sequence-specific transpeptidase.

In some instances, the polynucleic acid molecule is conjugated to the binding moiety by a method as described in U.S. Patent Publication Nos. 2015/0105539 and 2015/0105540.

Production of Antibodies or Binding Fragments Thereof

In some embodiments, polypeptides described herein (e.g., antibodies and its binding fragments) are produced using any method known in the art to be useful for the synthesis of polypeptides (e.g., antibodies), in particular, by chemical synthesis or by recombinant expression, and are preferably produced by recombinant expression techniques.

In some instances, an antibody or its binding fragment thereof is expressed recombinantly, and the nucleic acid encoding the antibody or its binding fragment is assembled from chemically synthesized oligonucleotides (e.g., as described in Kutmeier et al., 1994, BioTechniques 17:242), which involves the synthesis of overlapping oligonucleotides containing portions of the sequence encoding the antibody, annealing and ligation of those oligonucleotides, and then amplification of the ligated oligonucleotides by PCR.

Alternatively, a nucleic acid molecule encoding an antibody is optionally generated from a suitable source (e.g., an antibody cDNA library, or cDNA library generated from any tissue or cells expressing the immunoglobulin) by PCR amplification using synthetic primers hybridizable to the 3′ and 5′ ends of the sequence or by cloning using an oligonucleotide probe specific for the particular gene sequence.

In some instances, an antibody or its binding is optionally generated by immunizing an animal, such as a rabbit, to generate polyclonal antibodies or, more preferably, by generating monoclonal antibodies, e.g., as described by Kohler and Milstein (1975, Nature 256:495-497) or, as described by Kozbor et al. (1983, Immunology Today 4:72) or Cole et al. (1985 in Monoclonal Antibodies and Cancer Therapy, Alan R. Liss, Inc., pp. 77-96). Alternatively, a clone encoding at least the Fab portion of the antibody is optionally obtained by screening Fab expression libraries (e.g., as described in Huse et al., 1989, Science 246:1275-1281) for clones of Fab fragments that bind the specific antigen or by screening antibody libraries (See, e.g., Clackson et al., 1991, Nature 352:624; Hane et al., 1997 Proc. Natl. Acad. Sci. USA 94:4937).

In some embodiments, techniques developed for the production of “chimeric antibodies” (Morrison et al., 1984, Proc. Natl. Acad. Sci. 81:851-855; Neuberger et al., 1984, Nature 312:604-608; Takeda et al., 1985, Nature 314:452-454) by splicing genes from a mouse antibody molecule of appropriate antigen specificity together with genes from a human antibody molecule of appropriate biological activity are used. A chimeric antibody is a molecule in which different portions are derived from different animal species, such as those having a variable region derived from a murine monoclonal antibody and a human immunoglobulin constant region, e.g., humanized antibodies.

In some embodiments, techniques described for the production of single chain antibodies (U.S. Pat. No. 4,694,778; Bird, 1988, Science 242:423-42; Huston et al., 1988, Proc. Natl. Acad. Sci. USA 85:5879-5883; and Ward et al., 1989, Nature 334:544-54) are adapted to produce single chain antibodies. Single chain antibodies are formed by linking the heavy and light chain fragments of the Fv region via an amino acid bridge, resulting in a single chain polypeptide. Techniques for the assembly of functional Fv fragments in E. coli are also optionally used (Skerra et al., 1988, Science 242:1038-1041).

In some embodiments, an expression vector comprising the nucleotide sequence of an antibody or the nucleotide sequence of an antibody is transferred to a host cell by conventional techniques (e.g., electroporation, liposomal transfection, and calcium phosphate precipitation), and the transfected cells are then cultured by conventional techniques to produce the antibody. In specific embodiments, the expression of the antibody is regulated by a constitutive, an inducible or a tissue, specific promoter.

In some embodiments, a variety of host-expression vector systems is utilized to express an antibody or its binding fragment described herein. Such host-expression systems represent vehicles by which the coding sequences of the antibody is produced and subsequently purified, but also represent cells that are, when transformed or transfected with the appropriate nucleotide coding sequences, express an antibody or its binding fragment in situ. These include, but are not limited to, microorganisms such as bacteria (e.g., E. coli and B. subtilis) transformed with recombinant bacteriophage DNA, plasmid DNA or cosmid DNA expression vectors containing an antibody or its binding fragment coding sequences; yeast (e.g., Saccharomyces Pichia) transformed with recombinant yeast expression vectors containing an antibody or its binding fragment coding sequences; insect cell systems infected with recombinant virus expression vectors (e.g., baculovirus) containing an antibody or its binding fragment coding sequences; plant cell systems infected with recombinant virus expression vectors (e.g., cauliflower mosaic virus (CaMV) and tobacco mosaic virus (TMV)) or transformed with recombinant plasmid expression vectors (e.g., Ti plasmid) containing an antibody or its binding fragment coding sequences; or mammalian cell systems (e.g., COS, CHO, BH, 293, 293T, 3T3 cells) harboring recombinant expression constructs containing promoters derived from the genome of mammalian cells (e.g., metallothionein promoter) or from mammalian viruses (e.g. the adenovirus late promoter; the vaccinia virus 7.5K promoter).

For long-term, high-yield production of recombinant proteins, stable expression is preferred. In some instances, cell lines that stably express an antibody are optionally engineered. Rather than using expression vectors that contain viral origins of replication, host cells are transformed with DNA controlled by appropriate expression control elements (e.g., promoter, enhancer, sequences, transcription terminators, polyadenylation sites, etc.), and a selectable marker. Following the introduction of the foreign DNA, engineered cells are then allowed to grow for 1-2 days in an enriched media, and then are switched to a selective media. The selectable marker in the recombinant plasmid confers resistance to the selection and allows cells to stably integrate the plasmid into their chromosomes and grow to form foci that in turn are cloned and expanded into cell lines. This method can advantageously be used to engineer cell lines which express the antibody or its binding fragments.

In some instances, a number of selection systems are used, including but not limited to the herpes simplex virus thymidine kinase (Wigler et al., 1977, Cell 11:223), hypoxanthine-guanine phosphoribosyltransferase (Szybalska & Szybalski, 192, Proc. Natl. Acad. Sci. USA 48:202), and adenine phosphoribosyltransferase (Lowy et al., 1980, Cell 22:817) genes are employed in tk−, hgprt− or aprt− cells, respectively. Also, antimetabolite resistance are used as the basis of selection for the following genes: dhfr, which confers resistance to methotrexate (Wigler et al., 1980, Proc. Natl. Acad. Sci. USA 77:357; O'Hare et al., 1981, Proc. Natl. Acad. Sci. USA 78:1527); gpt, which confers resistance to mycophenolic acid (Mulligan & Berg, 1981, Proc. Natl. Acad. Sci. USA 78:2072); neo, which confers resistance to the aminoglycoside G-418 (Clinical Pharmacy 12:488-505; Wu and Wu, 1991, Biotherapy 3:87-95; Tolstoshev, 1993, Ann. Rev. Pharmacol. Toxicol. 32:573-596; Mulligan, 1993, Science 260:926-932; and Morgan and Anderson, 1993, Ann. Rev. Biochem. 62:191-217; May, 1993, TIB TECH 11(5):155-215) and hygro, which confers resistance to hygromycin (Santerre et al., 1984, Gene 30:147). Methods commonly known in the art of recombinant DNA technology which can be used are described in Ausubel et al. (eds., 1993, Current Protocols in Molecular Biology, John Wiley & Sons, NY; Kriegler, 1990, Gene Transfer and Expression, A Laboratory Manual, Stockton Press, NY; and in Chapters 12 and 13, Dracopoli et al. (eds), 1994, Current Protocols in Human Genetics, John Wiley & Sons, NY.; Colberre-Garapin et al., 1981, J. Mol. Biol. 150:1).

In some instances, the expression levels of an antibody are increased by vector amplification (for a review, see Bebbington and Hentschel, The use of vectors based on gene amplification for the expression of cloned genes in mammalian cells in DNA cloning, Vol. 3. (Academic Press, New York, 1987)). When a marker in the vector system expressing an antibody is amplifiable, an increase in the level of inhibitor present in culture of host cell will increase the number of copies of the marker gene. Since the amplified region is associated with the nucleotide sequence of the antibody, production of the antibody will also increase (Crouse et al., 1983, Mol. Cell Biol. 3:257).

In some instances, any method known in the art for purification or analysis of an antibody or antibody conjugates is used, for example, by chromatography (e.g., ion exchange, affinity, particularly by affinity for the specific antigen after Protein A, and sizing column chromatography), centrifugation, differential solubility, or by any other standard technique for the purification of proteins. Exemplary chromatography methods included, but are not limited to, strong anion exchange chromatography, hydrophobic interaction chromatography, size exclusion chromatography, and fast protein liquid chromatography.

Polymer Conjugating Moiety

In some embodiments, a polymer moiety C is further conjugated to a polynucleic acid molecule described herein, a binding moiety described herein, or in combinations thereof. In some instances, a polymer moiety C is conjugated a polynucleic acid molecule. In some cases, a polymer moiety C is conjugated to a binding moiety. In other cases, a polymer moiety C is conjugated to a polynucleic acid molecule-binding moiety molecule. In additional cases, a polymer moiety C is conjugated, as illustrated supra.

In some instances, the polymer moiety C is a natural or synthetic polymer, consisting of long chains of branched or unbranched monomers, and/or cross-linked network of monomers in two or three dimensions. In some instances, the polymer moiety C includes a polysaccharide, lignin, rubber, or polyalkylen oxide (e.g., polyethylene glycol). In some instances, the at least one polymer moiety C includes, but is not limited to, alpha-, omega-dihydroxylpolyethyleneglycol, biodegradable lactone-based polymer, e.g. polyacrylic acid, polylactide acid (PLA), poly(glycolic acid) (PGA), polypropylene, polystyrene, polyolefin, polyamide, polycyanoacrylate, polyimide, polyethylenterephthalat (PET, PETG), polyethylene terephthalate (PETE), polytetramethylene glycol (PTG), or polyurethane as well as mixtures thereof. As used herein, a mixture refers to the use of different polymers within the same compound as well as in reference to block copolymers. In some cases, block copolymers are polymers wherein at least one section of a polymer is build up from monomers of another polymer. In some instances, the polymer moiety C comprises polyalkylene oxide. In some instances, the polymer moiety C comprises PEG. In some instances, the polymer moiety C comprises polyethylene imide (PEI) or hydroxy ethyl starch (HES).

In some instances, C is a PEG moiety. In some instances, the PEG moiety is conjugated at the 5′ terminus of the polynucleic acid molecule while the binding moiety is conjugated at the 3′ terminus of the polynucleic acid molecule. In some instances, the PEG moiety is conjugated at the 3′ terminus of the polynucleic acid molecule while the binding moiety is conjugated at the 5′ terminus of the polynucleic acid molecule. In some instances, the PEG moiety is conjugated to an internal site of the polynucleic acid molecule. In some instances, the PEG moiety, the binding moiety, or a combination thereof, are conjugated to an internal site of the polynucleic acid molecule. In some instances, the conjugation is a direct conjugation. In some instances, the conjugation is via native ligation.

In some embodiments, the polyalkylene oxide (e.g., PEG) is a polydispers or monodispers compound. In some instances, polydispers material comprises disperse distribution of different molecular weight of the material, characterized by mean weight (weight average) size and dispersity. In some instances, the monodisperse PEG comprises one size of molecules. In some embodiments, C is poly- or monodispersed polyalkylene oxide (e.g., PEG) and the indicated molecular weight represents an average of the molecular weight of the polyalkylene oxide, e.g., PEG, molecules.

In some embodiments, the molecular weight of the polyalkylene oxide (e.g., PEG) is about 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1100, 1200, 1300, 1400, 1450, 1500, 1600, 1700, 1800, 1900, 2000, 2100, 2200, 2300, 2400, 2500, 2600, 2700, 2800, 2900, 3000, 3250, 3350, 3500, 3750, 4000, 4250, 4500, 4600, 4750, 5000, 5500, 6000, 6500, 7000, 7500, 8000, 10,000, 12,000, 20,000, 35,000, 40,000, 50,000, 60,000, or 100,000 Da.

In some embodiments, C is polyalkylene oxide (e.g., PEG) and has a molecular weight of about 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1100, 1200, 1300, 1400, 1450, 1500, 1600, 1700, 1800, 1900, 2000, 2100, 2200, 2300, 2400, 2500, 2600, 2700, 2800, 2900, 3000, 3250, 3350, 3500, 3750, 4000, 4250, 4500, 4600, 4750, 5000, 5500, 6000, 6500, 7000, 7500, 8000, 10,000, 12,000, 20,000, 35,000, 40,000, 50,000, 60,000, or 100,000 Da. In some embodiments, C is PEG and has a molecular weight of about 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1100, 1200, 1300, 1400, 1450, 1500, 1600, 1700, 1800, 1900, 2000, 2100, 2200, 2300, 2400, 2500, 2600, 2700, 2800, 2900, 3000, 3250, 3350, 3500, 3750, 4000, 4250, 4500, 4600, 4750, 5000, 5500, 6000, 6500, 7000, 7500, 8000, 10,000, 12,000, 20,000, 35,000, 40,000, 50,000, 60,000, or 100,000 Da. In some instances, the molecular weight of C is about 200 Da. In some instances, the molecular weight of C is about 300 Da. In some instances, the molecular weight of C is about 400 Da. In some instances, the molecular weight of C is about 500 Da. In some instances, the molecular weight of C is about 600 Da. In some instances, the molecular weight of C is about 700 Da. In some instances, the molecular weight of C is about 800 Da. In some instances, the molecular weight of C is about 900 Da. In some instances, the molecular weight of C is about 1000 Da. In some instances, the molecular weight of C is about 1100 Da. In some instances, the molecular weight of C is about 1200 Da. In some instances, the molecular weight of C is about 1300 Da. In some instances, the molecular weight of C is about 1400 Da. In some instances, the molecular weight of C is about 1450 Da. In some instances, the molecular weight of C is about 1500 Da. In some instances, the molecular weight of C is about 1600 Da. In some instances, the molecular weight of C is about 1700 Da. In some instances, the molecular weight of C is about 1800 Da. In some instances, the molecular weight of C is about 1900 Da. In some instances, the molecular weight of C is about 2000 Da. In some instances, the molecular weight of C is about 2100 Da. In some instances, the molecular weight of C is about 2200 Da. In some instances, the molecular weight of C is about 2300 Da. In some instances, the molecular weight of C is about 2400 Da. In some instances, the molecular weight of C is about 2500 Da. In some instances, the molecular weight of C is about 2600 Da. In some instances, the molecular weight of C is about 2700 Da. In some instances, the molecular weight of C is about 2800 Da. In some instances, the molecular weight of C is about 2900 Da. In some instances, the molecular weight of C is about 3000 Da. In some instances, the molecular weight of C is about 3250 Da. In some instances, the molecular weight of C is about 3350 Da. In some instances, the molecular weight of C is about 3500 Da. In some instances, the molecular weight of C is about 3750 Da. In some instances, the molecular weight of C is about 4000 Da. In some instances, the molecular weight of C is about 4250 Da. In some instances, the molecular weight of C is about 4500 Da. In some instances, the molecular weight of C is about 4600 Da. In some instances, the molecular weight of C is about 4750 Da. In some instances, the molecular weight of C is about 5000 Da. In some instances, the molecular weight of C is about 5500 Da. In some instances, the molecular weight of C is about 6000 Da. In some instances, the molecular weight of C is about 6500 Da. In some instances, the molecular weight of C is about 7000 Da. In some instances, the molecular weight of C is about 7500 Da. In some instances, the molecular weight of C is about 8000 Da. In some instances, the molecular weight of C is about 10,000 Da. In some instances, the molecular weight of C is about 12,000 Da. In some instances, the molecular weight of C is about 20,000 Da. In some instances, the molecular weight of C is about 35,000 Da. In some instances, the molecular weight of C is about 40,000 Da. In some instances, the molecular weight of C is about 50,000 Da. In some instances, the molecular weight of C is about 60,000 Da. In some instances, the molecular weight of C is about 100,000 Da.

In some embodiments, the polyalkylene oxide (e.g., PEG) comprises discrete ethylene oxide units (e.g., four to about 48 ethylene oxide units). In some instances, the polyalkylene oxide comprising the discrete ethylene oxide units is a linear chain. In other cases, the polyalkylene oxide comprising the discrete ethylene oxide units is a branched chain.

In some instances, the polymer moiety C is a polyalkylene oxide (e.g., PEG) comprising discrete ethylene oxide units. In some cases, the polymer moiety C comprises between about 4 and about 48 ethylene oxide units. In some cases, the polymer moiety C comprises about 4, about 5, about 6, about 7, about 8, about 9, about 10, about 11, about 12, about 13, about 14, about 15, about 16, about 17, about 18, about 19, about 20, about 21, about 22, about 23, about 24, about 25, about 26, about 27, about 28, about 29, about 30, about 31, about 32, about 33, about 34, about 35, about 36, about 37, about 38, about 39, about 40, about 41, about 42, about 43, about 44, about 45, about 46, about 47, or about 48 ethylene oxide units.

In some instances, the polymer moiety C is a discrete PEG comprising, e.g., between about 4 and about 48 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 4, about 5, about 6, about 7, about 8, about 9, about 10, about 11, about 12, about 13, about 14, about 15, about 16, about 17, about 18, about 19, about 20, about 21, about 22, about 23, about 24, about 25, about 26, about 27, about 28, about 29, about 30, about 31, about 32, about 33, about 34, about 35, about 36, about 37, about 38, about 39, about 40, about 41, about 42, about 43, about 44, about 45, about 46, about 47, or about 48 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 4 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 5 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 6 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 7 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 8 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 9 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 10 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 11 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 12 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 13 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 14 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 15 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 16 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 17 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 18 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 19 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 20 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 21 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 22 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 23 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 24 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 25 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 26 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 27 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 28 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 29 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 30 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 31 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 32 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 33 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 34 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 35 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 36 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 37 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 38 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 39 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 40 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 41 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 42 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 43 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 44 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 45 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 46 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 47 ethylene oxide units. In some cases, the polymer moiety C is a discrete PEG comprising, e.g., about 48 ethylene oxide units.

In some cases, the polymer moiety C is dPEG® (Quanta Biodesign Ltd).

In some embodiments, the polymer moiety C comprises a cationic mucic acid-based polymer (cMAP). In some instances, cMAP comprises one or more subunit of at least one repeating subunit, and the subunit structure is represented as Formula (V):

wherein m is independently at each occurrence 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10, preferably 4-6 or 5; and n is independently at each occurrence 1, 2, 3, 4, or 5. In some embodiments, m and n are, for example, about 10.

In some instances, cMAP is further conjugated to a PEG moiety, generating a cMAP-PEG copolymer, an mPEG-cMAP-PEGm triblock polymer, or a cMAP-PEG-cMAP triblock polymer. In some instances, the PEG moiety is in a range of from about 500 Da to about 50,000 Da. In some instances, the PEG moiety is in a range of from about 500 Da to about 1000 Da, greater than 1000 Da to about 5000 Da, greater than 5000 Da to about 10,000 Da, greater than 10,000 to about 25,000 Da, greater than 25,000 Da to about 50,000 Da, or any combination of two or more of these ranges.

In some instances, the polymer moiety C is cMAP-PEG copolymer, an mPEG-cMAP-PEGm triblock polymer, or a cMAP-PEG-cMAP triblock polymer. In some cases, the polymer moiety C is cMAP-PEG copolymer. In other cases, the polymer moiety C is an mPEG-cMAP-PEGm triblock polymer. In additional cases, the polymer moiety C is a cMAP-PEG-cMAP triblock polymer.

In some embodiments, the polymer moiety C is conjugated to the polynucleic acid molecule, the binding moiety, and optionally to the endosomolytic moiety as illustrated supra.

Endosomolytic Moiety

In some embodiments, a molecule of Formula (I): A-X-B-Y-C, further comprises an additional conjugating moiety. In some instances, the additional conjugating moiety is an endosomolytic moiety. In some cases, the endosomolytic moiety is a cellular compartmental release component, such as a compound capable of releasing from any of the cellular compartments known in the art, such as the endosome, lysosome, endoplasmic reticulum (ER), golgi apparatus, microtubule, peroxisome, or other vesicular bodies with the cell. In some cases, the endosomolytic moiety comprises an endosomolytic polypeptide, an endosomolytic polymer, an endosomolytic lipid, or an endosomolytic small molecule. In some cases, the endosomolytic moiety comprises an endosomolytic polypeptide. In other cases, the endosomolytic moiety comprises an endosomolytic polymer.

Endosomolytic Polypeptides

In some embodiments, a molecule of Formula (I): A-X-B-Y-C, is further conjugated with an endosomolytic polypeptide. In some cases, the endosomolytic polypeptide is a pH-dependent membrane active peptide. In some cases, the endosomolytic polypeptide is an amphipathic polypeptide. In additional cases, the endosomolytic polypeptide is a peptidomimetic. In some instances, the endosomolytic polypeptide comprises INF, melittin, meucin, or their respective derivatives thereof. In some instances, the endosomolytic polypeptide comprises INF or its derivatives thereof. In other cases, the endosomolytic polypeptide comprises melittin or its derivatives thereof. In additional cases, the endosomolytic polypeptide comprises meucin or its derivatives thereof.

In some instances, INF7 is a 24 residue polypeptide those sequence comprises CGIFGEIEELIEEGLENLIDWGNA (SEQ ID NO: 1), or GLFEAIEGFIENGWEGMIDGWYGC (SEQ ID NO: 2). In some instances, INF7 or its derivatives comprise a sequence of: GLFEAIEGFIENGWEGMIWDYGSGSCG (SEQ ID NO: 3), GLFEAIEGFIENGWEGMIDG WYG-(PEG)6-NH2 (SEQ ID NO: 4), or GLFEAIEGFIENGWEGMIWDYG-SGSC-K(GalNAc)2 (SEQ ID NO: 5).

In some cases, melittin is a 26 residue polypeptide those sequence comprises CLIGAILKVLATGLPTLISWIKNKRKQ (SEQ ID NO: 6), or GIGAVLKVLTTGLPALISWIKRKRQQ (SEQ ID NO: 7). In some instances, melittin comprises a polypeptide sequence as described in U.S. Pat. No. 8,501,930.

In some instances, meucin is an antimicrobial peptide (AMP) derived from the venom gland of the scorpion Mesobuthus eupeus. In some instances, meucin comprises of meucin-13 those sequence comprises IFGAIAGLLKNIF-NH₂ (SEQ ID NO: 8) and meucin-18 those sequence comprises FFGHLFKLATKIIPSLFQ (SEQ ID NO: 9).

In some instances, the endosomolytic polypeptide comprises a polypeptide in which its sequence is at least 50%, 60%, 70%, 80%, 90%, 95%, or 99% sequence identity to INF7 or its derivatives thereof, melittin or its derivatives thereof, or meucin or its derivatives thereof. In some instances, the endosomolytic moiety comprises INF7 or its derivatives thereof, melittin or its derivatives thereof, or meucin or its derivatives thereof.

In some instances, the endosomolytic moiety is INF7 or its derivatives thereof. In some cases, the endosomolytic moiety comprises a polypeptide having at least 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99%, or 100% sequence identity to SEQ ID NOs: 1-5. In some cases, the endosomolytic moiety comprises a polypeptide having at least 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99%, or 100% sequence identity to SEQ ID NO: 1. In some cases, the endosomolytic moiety comprises a polypeptide having at least 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99%, or 100% sequence identity to SEQ ID NO: 2-5. In some cases, the endosomolytic moiety comprises SEQ ID NO: 1. In some cases, the endosomolytic moiety comprises SEQ ID NO: 2-5. In some cases, the endosomolytic moiety consists of SEQ ID NO: 1. In some cases, the endosomolytic moiety consists of SEQ ID NO: 2-5.

In some instances, the endosomolytic moiety is melittin or its derivatives thereof. In some cases, the endosomolytic moiety comprises a polypeptide having at least 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99%, or 100% sequence identity to SEQ ID NOs: 6 or 7. In some cases, the endosomolytic moiety comprises a polypeptide having at least 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99%, or 100% sequence identity to SEQ ID NO: 6. In some cases, the endosomolytic moiety comprises a polypeptide having at least 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99%, or 100% sequence identity to SEQ ID NO: 7. In some cases, the endosomolytic moiety comprises SEQ ID NO: 6. In some cases, the endosomolytic moiety comprises SEQ ID NO: 7. In some cases, the endosomolytic moiety consists of SEQ ID NO: 6. In some cases, the endosomolytic moiety consists of SEQ ID NO: 7.

In some instances, the endosomolytic moiety is meucin or its derivatives thereof. In some cases, the endosomolytic moiety comprises a polypeptide having at least 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99%, or 100% sequence identity to SEQ ID NOs: 8 or 9. In some cases, the endosomolytic moiety comprises a polypeptide having at least 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99%, or 100% sequence identity to SEQ ID NO: 8. In some cases, the endosomolytic moiety comprises a polypeptide having at least 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99%, or 100% sequence identity to SEQ ID NO: 9. In some cases, the endosomolytic moiety comprises SEQ ID NO: 8. In some cases, the endosomolytic moiety comprises SEQ ID NO: 9. In some cases, the endosomolytic moiety consists of SEQ ID NO: 8. In some cases, the endosomolytic moiety consists of SEQ ID NO: 9.

In some instances, the endosomolytic moiety comprises a sequence as illustrated in Table 1.

TABLE 1 SEQ ID Name Origin Amino Acid Sequence NO: Type Pep-1 NLS from Simian Virus KETWWETWWTEWSQPKKKRKV 10 Primary 40 large antigen and amphipathic Reverse transcriptase of HIV pVEC VE-cadherin LLIILRRRRIRKQAHAHSK 11 Primary amphipathic VT5 Synthetic peptide DPKGDPKGVTVTVTVTVTGKGDP 12 β-sheet KPD amphipathic C105Y 1-antitrypsin CSIPPEVKFNKPFVYLI 13 — Transportan Galanin and mastoparan GWTLNSAGYLLGKINLKALAALA 14 Primary KKIL amphipathic TP10 Galanin and mastoparan AGYLLGKINLKALAALAKKIL 15 Primary amphipathic MPG A hydrofobic domain GALFLGFLGAAGSTMGA 16 β-sheet from the fusion amphipathic sequence of HIV gp41 and NLS of 5V40 T antigen gH625 Glycoprotein gH of HGLASTLTRWAHYNALIRAF 17 Secondary HSV type I amphipathic α-helical CADY PPTG1 peptide GLWRALWRLLRSLWRLLWRA 18 Secondary amphipathic α-helical GALA Synthetic peptide WEAALAEALAEALAEHLAEALAE 19 Secondary ALEALAA amphipathic α-helical INF Influenza HA2 fusion GLFEAIEGFIENGWEGMIDGWYGC 20 Secondary peptide amphipathic α-helical/ pH- dependent membrane active peptide HA2E5- Influenza HA2 subunit GLFGAIAGFIENGWEGMIDGWYG 21 Secondary TAT of influenza virus X31 amphipathic strain fusion peptide α-helical/ pH- dependent membrane active peptide HA2- Influenza HA2 subunit GLFGAIAGFIENGWEGMIDGRQIKI 22 pH- penetratin of influenza virus X31 WFQNRRMKW dependent strain fusion peptide KK-amide membrane active peptide HA-K4 Influenza HA2 subunit GLFGAIAGFIENGWEGMIDG- 23 pH- of influenza virus X31 SSKKKK dependent strain fusion peptide membrane active peptide HA2E4 Influenza HA2 subunit GLFEAIAGFIENGWEGMIDGGGYC 24 pH- of influenza virus X31 dependent strain fusion peptide membrane active peptide H5WYG HA2 analogue GLFHAIAHFIHGGWH 25 pH- GLIHGWYG dependent membrane active peptide GALA- INF3 fusion peptide GLFEAIEGFIENGWEGLAEALAEAL 26 pH- INF3- EALAA- dependent (PEG)6-NH (PEG)6-NH2 membrane active peptide CM18- Cecropin-A-Melittin₂₋₁₂ KWKLFKKIGAVLKVLTTG- 27 pH- TAT11 (CM₁₈) fusion peptide YGRKKRRQRRR dependent membrane active peptide

In some cases, the endosomolytic moiety comprises a Bak BH3 polypeptide which induces apoptosis through antagonization of suppressor targets such as Bcl-2 and/or Bcl-xL. In some instances, the endosomolytic moiety comprises a Bak BH3 polypeptide described in Albarran, et al., “Efficient intracellular delivery of a pro-apoptotic peptide with a pH-responsive carrier,” Reactive & Functional Polymers 71: 261-265 (2011).

In some instances, the endosomolytic moiety comprises a polypeptide (e.g., a cell-penetrating polypeptide) as described in PCT Publication Nos. WO2013/166155 or WO2015/069587.

Linkers

In some embodiments, a linker described herein is a cleavable linker or a non-cleavable linker. In some instances, the linker is a cleavable linker. In other instances, the linker is a non-cleavable linker.

In some cases, the linker is a non-polymeric linker. A non-polymeric linker refers to a linker that does not contain a repeating unit of monomers generated by a polymerization process. Exemplary non-polymeric linkers include, but are not limited to, C₁-C₆ alkyl group (e.g., a C₅, C₄, C₃, C₂, or C₁ alkyl group), homobifunctional cross linkers, heterobifunctional cross linkers, peptide linkers, traceless linkers, self-immolative linkers, maleimide-based linkers, or combinations thereof. In some cases, the non-polymeric linker comprises a C₁-C₆ alkyl group (e.g., a C₅, C₄, C₃, C₂, or C₁ alkyl group), a homobifunctional cross linker, a heterobifunctional cross linker, a peptide linker, a traceless linker, a self-immolative linker, a maleimide-based linker, or a combination thereof. In additional cases, the non-polymeric linker does not comprise more than two of the same type of linkers, e.g., more than two homobifunctional cross linkers, or more than two peptide linkers. In further cases, the non-polymeric linker optionally comprises one or more reactive functional groups.

In some instances, the non-polymeric linker does not encompass a polymer that is described above. In some instances, the non-polymeric linker does not encompass a polymer encompassed by the polymer moiety C. In some cases, the non-polymeric linker does not encompass a polyalkylene oxide (e.g., PEG). In some cases, the non-polymeric linker does not encompass a PEG.

In some instances, the linker comprises a homobifunctional linker. Exemplary homobifunctional linkers include, but are not limited to, Lomant's reagent dithiobis (succinimidylpropionate) DSP, 3′3′-dithiobis(sulfosuccinimidyl proprionate (DTS SP), disuccinimidyl suberate (DSS), bis(sulfosuccinimidyl)suberate (BS), disuccinimidyl tartrate (DST), disulfosuccinimidyl tartrate (sulfo DST), ethylene glycobis(succinimidylsuccinate) (EGS), disuccinimidyl glutarate (DSG), N,N′-disuccinimidyl carbonate (DSC), dimethyl adipimidate (DMA), dimethyl pimelimidate (DMP), dimethyl suberimidate (DMS), dimethyl-3,3′-dithiobispropionimidate (DTBP), 1,4-di-3′-(2′-pyridyldithio)propionamido)butane (DPDPB), bismaleimidohexane (BMH), aryl halide-containing compound (DFDNB), such as e.g. 1,5-difluoro-2,4-dinitrobenzene or 1,3-difluoro-4,6-dinitrobenzene, 4,4′-difluoro-3,3′-dinitrophenylsulfone (DFDNPS), bis-[β-(4-azidosalicylamido)ethyl]disulfide (BASED), formaldehyde, glutaraldehyde, 1,4-butanediol diglycidyl ether, adipic acid dihydrazide, carbohydrazide, o-toluidine, 3,3′-dimethylbenzidine, benzidine, α,α′-p-diaminodiphenyl, diiodo-p-xylene sulfonic acid, N,N′-ethylene-bis(iodoacetamide), or N,N′-hexamethylene-bis(iodoacetamide).

In some embodiments, the linker comprises a heterobifunctional linker. Exemplary heterobifunctional linker include, but are not limited to, amine-reactive and sulfhydryl cross-linkers such as N-succinimidyl 3-(2-pyridyldithio)propionate (sPDP), long-chain N-succinimidyl 3-(2-pyridyldithio)propionate (LC-sPDP), water-soluble-long-chain N-succinimidyl 3-(2-pyridyldithio) propionate (sulfo-LC-sPDP), succinimidyloxycarbonyl-α-methyl-α-(2-pyridyldithio)toluene (sMPT), sulfosuccinimidyl-64α-methyl-α-(2-pyridyldithio)toluamidolhexanoate (sulfo-LC-sMPT), succinimidyl-4-(N-maleimidomethyl)cyclohexane-1-carboxylate (sMCC), sulfosuccinimidyl-4-(N-maleimidomethyl)cyclohexane-1-carboxylate (sulfo-sMCC), m-maleimidobenzoyl-N-hydroxysuccinimide ester (MBs), m-maleimidobenzoyl-N-hydroxysulfosuccinimide ester (sulfo-MBs), N-succinimidyl(4-iodoacteyl)aminobenzoate (sIAB), sulfosuccinimidyl(4-iodoacteyl)aminobenzoate (sulfo-sIAB), succinimidyl-4-(p-maleimidophenyObutyrate (sMPB), sulfosuccinimidyl-4-(p-maleimidophenyl)butyrate (sulfo-sMPB), N-(γ-maleimidobutyryloxy)succinimide ester (GMBs), N-(γ-maleimidobutyryloxy)sulfosuccinimide ester (sulfo-GMBs), succinimidyl 6-((iodoacetyl)amino)hexanoate (sIAX), succinimidyl 6-[6-(((iodoacetyl)amino)hexanoyl)amino]hexanoate (sIAXX), succinimidyl 4-(((iodoacetyl)amino)methyl)cyclohexane-1-carboxylate (sIAC), succinimidyl 6-((((4-iodoacetyl)amino)methyl)cyclohexane-1-carbonyl)amino) hexanoate (sIACX), p-nitrophenyl iodoacetate (NPIA), carbonyl-reactive and sulfhydryl-reactive cross-linkers such as 4-(4-N-maleimidophenyl)butyric acid hydrazide (MPBH), 4-(N-maleimidomethyl)cyclohexane-1-carboxyl-hydrazide-8 (M₂C₂H), 3-(2-pyridyldithio)propionyl hydrazide (PDPH), amine-reactive and photoreactive cross-linkers such as N-hydroxysuccinimidyl-4-azidosalicylic acid (NHs-AsA), N-hydroxysulfosuccinimidyl-4-azidosalicylic acid (sulfo-NHs-AsA), sulfosuccinimidyl-(4-azidosalicylamido)hexanoate (sulfo-NHs-LC-AsA), sulfosuccinimidyl-2-(ρ-azidosalicylamido)ethyl-1,3′-dithiopropionate (sAsD), N-hydroxysuccinimidyl-4-azidobenzoate (HsAB), N-hydroxysulfosuccinimidyl-4-azidobenzoate (sulfo-HsAB), N-succinimidyl-6-(4′-azido-2′-nitrophenylamino)hexanoate (sANPAH), sulfosuccinimidyl-6-(4′-azido-2′-nitrophenylamino)hexanoate (sulfo-sANPAH), N-5-azido-2-nitrobenzoyloxysuccinimide (ANB-NOs), sulfosuccinimidyl-2-(m-azido-o-nitrobenzamido)-ethyl-1,3′-dithiopropionate (sAND), N-succinimidyl-4(4-azidophenyl)1,3′-dithiopropionate (sADP), N-sulfosuccinimidyl(4-azidophenyl)-1,3′-dithiopropionate (sulfo-sADP), sulfosuccinimidyl 4-(ρ-azidophenyl)butyrate (sulfo-sAPB), sulfosuccinimidyl 2-(7-azido-4-methylcoumarin-3-acetamide)ethyl-1,3′-dithiopropionate (sAED), sulfosuccinimidyl 7-azido-4-methylcoumain-3-acetate (sulfo-sAMCA), ρ-nitrophenyl diazopyruvate (ρNPDP), ρ-nitrophenyl-2-diazo-3,3,3-trifluoropropionate (PNP-DTP), sulfhydryl-reactive and photoreactive cross-linkers such as 1-(ρ-Azidosalicylamido)-4-(iodoacetamido)butane (AsIB), N-[4-(ρ-azidosalicylamido)butyl]-3′-(2′-pyridyldithio)propionamide (APDP), benzophenone-4-iodoacetamide, benzophenone-4-maleimide carbonyl-reactive and photoreactive cross-linkers such as ρ-azidobenzoyl hydrazide (ABH), carboxylate-reactive and photoreactive cross-linkers such as 4-(ρ-azidosalicylamido)butylamine (AsBA), and arginine-reactive and photoreactive cross-linkers such as ρ-azidophenyl glyoxal (APG).

In some instances, the linker comprises a reactive functional group. In some cases, the reactive functional group comprises a nucleophilic group that is reactive to an electrophilic group present on a binding moiety. Exemplary electrophilic groups include carbonyl groups—such as aldehyde, ketone, carboxylic acid, ester, amide, enone, acyl halide or acid anhydride. In some embodiments, the reactive functional group is aldehyde. Exemplary nucleophilic groups include hydrazide, oxime, amino, hydrazine, thiosemicarbazone, hydrazine carboxylate, and arylhydrazide.

In some embodiments, the linker comprises a maleimide group. In some instances, the maleimide group is also referred to as a maleimide spacer. In some instances, the maleimide group further encompasses a caproic acid, forming maleimidocaproyl (mc). In some cases, the linker comprises maleimidocaproyl (mc). In some cases, the linker is maleimidocaproyl (mc). In other instances, the maleimide group comprises a maleimidomethyl group, such as succinimidyl-4-(N-maleimidomethyl)cyclohexane-1-carboxylate (sMCC) or sulfosuccinimidyl-4-(N-maleimidomethyl)cyclohexane-1-carboxylate (sulfo-sMCC) described above.

In some embodiments, the maleimide group is a self-stabilizing maleimide. In some instances, the self-stabilizing maleimide utilizes diaminopropionic acid (DPR) to incorporate a basic amino group adjacent to the maleimide to provide intramolecular catalysis of tiosuccinimide ring hydrolysis, thereby eliminating maleimide from undergoing an elimination reaction through a retro-Michael reaction. In some instances, the self-stabilizing maleimide is a maleimide group described in Lyon, et al., “Self-hydrolyzing maleimides improve the stability and pharmacological properties of antibody-drug conjugates,” Nat. Biotechnol. 32(10):1059-1062 (2014). In some instances, the linker comprises a self-stabilizing maleimide. In some instances, the linker is a self-stabilizing maleimide.

In some embodiments, the linker comprises a peptide moiety. In some instances, the peptide moiety comprises at least 2, 3, 4, 5, 6, 7, 8, or more amino acid residues. In some instances, the peptide moiety is a cleavable peptide moiety (e.g., either enzymatically or chemically). In some instances, the peptide moiety is a non-cleavable peptide moiety. In some instances, the peptide moiety comprises Val-Cit (valine-citrulline), Gly-Gly-Phe-Gly (SEQ ID NO: 973), Phe-Lys, Val-Lys, Gly-Phe-Lys, Phe-Phe-Lys, Ala-Lys, Val-Arg, Phe-Cit, Phe-Arg, Leu-Cit, Ile-Cit, Trp-Cit, Phe-Ala, Ala-Leu-Ala-Leu (SEQ ID NO: 974), or Gly-Phe-Leu-Gly (SEQ ID NO: 975). In some instances, the linker comprises a peptide moiety such as: Val-Cit (valine-citrulline), Gly-Gly-Phe-Gly (SEQ ID NO: 973), Phe-Lys, Val-Lys, Gly-Phe-Lys, Phe-Phe-Lys, Ala-Lys, Val-Arg, Phe-Cit, Phe-Arg, Leu-Cit, Ile-Cit, Trp-Cit, Phe-Ala, Ala-Leu-Ala-Leu (SEQ ID NO: 974), or Gly-Phe-Leu-Gly (SEQ ID NO: 975). In some cases, the linker comprises Val-Cit. In some cases, the linker is Val-Cit.

In some embodiments, the linker comprises a benzoic acid group, or its derivatives thereof. In some instances, the benzoic acid group or its derivatives thereof comprise paraaminobenzoic acid (PABA). In some instances, the benzoic acid group or its derivatives thereof comprise gamma-aminobutyric acid (GABA).

In some embodiments, the linker comprises one or more of a maleimide group, a peptide moiety, and/or a benzoic acid group, in any combination. In some embodiments, the linker comprises a combination of a maleimide group, a peptide moiety, and/or a benzoic acid group. In some instances, the maleimide group is maleimidocaproyl (mc). In some instances, the peptide group is val-cit. In some instances, the benzoic acid group is PABA. In some instances, the linker comprises a mc-val-cit group. In some cases, the linker comprises a val-cit-PABA group. In additional cases, the linker comprises a mc-val-cit-PABA group.

In some embodiments, the linker is a self-immolative linker or a self-elimination linker. In some cases, the linker is a self-immolative linker. In other cases, the linker is a self-elimination linker (e.g., a cyclization self-elimination linker). In some instances, the linker comprises a linker described in U.S. Pat. No. 9,089,614 or PCT Publication No. WO2015038426.

In some embodiments, the linker is a dendritic type linker. In some instances, the dendritic type linker comprises a branching, multifunctional linker moiety. In some instances, the dendritic type linker is used to increase the molar ratio of polynucleotide B to the binding moiety A. In some instances, the dendritic type linker comprises PAMAM dendrimers.

In some embodiments, the linker is a traceless linker or a linker in which after cleavage does not leave behind a linker moiety (e.g., an atom or a linker group) to a binding moiety A, a polynucleotide B, a polymer C, or an endosomolytic moiety D. Exemplary traceless linkers include, but are not limited to, germanium linkers, silicium linkers, sulfur linkers, selenium linkers, nitrogen linkers, phosphorus linkers, boron linkers, chromium linkers, or phenylhydrazide linker. In some cases, the linker is a traceless aryl-triazene linker as described in Hejesen, et al., “A traceless aryl-triazene linker for DNA-directed chemistry,” Org Biomol Chem 11(15): 2493-2497 (2013). In some instances, the linker is a traceless linker described in Blaney, et al., “Traceless solid-phase organic synthesis,” Chem. Rev. 102: 2607-2024 (2002). In some instances, a linker is a traceless linker as described in U.S. Pat. No. 6,821,783.

In some instances, the linker is a linker described in U.S. Pat. Nos. 6,884,869; 7,498,298; 8,288,352; 8,609,105; or 8,697,688; U.S. Patent Publication Nos. 2014/0127239; 2013/028919; 2014/286970; 2013/0309256; 2015/037360; or 2014/0294851; or PCT Publication Nos. WO2015057699; WO2014080251; WO2014197854; WO2014145090; or WO2014177042.

In some embodiments, X, Y, and L are independently a bond or a linker. In some instances, X, Y, and L are independently a bond. In some cases, X, Y, and L are independently a linker.

In some instances, X is a bond or a linker, e.g., a non-polymeric linker. In some instances, X is a bond. In some instances, X is a non-polymeric linker. In some instances, the non-polymeric linker is a C₁-C₆ alkyl group. In some cases, X is a C₁-C₆ alkyl group, such as for example, a C₅, C₄, C₃, C₂, or C₁ alkyl group. In some cases, the C₁-C₆ alkyl group is an unsubstituted C₁-C₆ alkyl group. As used in the context of a non-polymeric linker, and in particular in the context of X, alkyl means a saturated straight or branched hydrocarbon radical containing up to six carbon atoms. In some instances, X includes a homobifunctional linker or a heterobifunctional linker described supra. In some cases, X includes a heterobifunctional linker. In some cases, X includes sMCC. In other instances, X includes a heterobifunctional linker optionally conjugated to a C₁-C₆ alkyl group. In other instances, X includes sMCC optionally conjugated to a C₁-C₆ alkyl group. In additional instances, X does not encompass a polymer encompassed by the polymer moiety C, e.g., X does not encompass a polyalkylene oxide (e.g., a PEG molecule).

In some instances, Y is a bond or a linker, e.g., a non-polymeric linker. In some instances, Y is a bond. In other cases, Y is a non-polymeric linker. In some embodiments, Y is a C₁-C₆ alkyl group. In some instances, Y is a homobifunctional linker or a heterobifunctional linker described supra. In some instances, Y is a homobifunctional linker described supra. In some instances, Y is a heterobifunctional linker described supra. In some instances, Y comprises a maleimide group, such as maleimidocaproyl (mc) or a self-stabilizing maleimide group described above. In some instances, Y comprises a peptide moiety, such as Val-Cit. In some instances, Y comprises a benzoic acid group, such as PABA. In additional instances, Y comprises a combination of a maleimide group, a peptide moiety, and/or a benzoic acid group. In additional instances, Y comprises a mc group. In additional instances, Y comprises a mc-val-cit group. In additional instances, Y comprises a val-cit-PABA group. In additional instances, Y comprises a mc-val-cit-PABA group. In some cases, Y does not encompass a polymer encompassed by the polymer moiety C, e.g., Y does not encompass a polyalkylene oxide (e.g., a PEG molecule).

In some instances, L is a bond or a linker, optionally a non-polymeric linker. In some cases, L is a bond. In other cases, L is a linker, optionally a non-polymeric linker. In some embodiments, L is a C₁-C₆ alkyl group. In some instances, L is a homobifunctional linker or a heterobifunctional linker described supra. In some instances, L is a homobifunctional linker described supra. In some instances, L is a heterobifunctional linker described supra. In some instances, L comprises a maleimide group, such as maleimidocaproyl (mc) or a self-stabilizing maleimide group described above. In some instances, L comprises a peptide moiety, such as Val-Cit. In some instances, L comprises a benzoic acid group, such as PABA. In additional instances, L comprises a combination of a maleimide group, a peptide moiety, and/or a benzoic acid group. In additional instances, L comprises a mc group. In additional instances, L comprises a mc-val-cit group. In additional instances, L comprises a val-cit-PABA group. In additional instances, L comprises a mc-val-cit-PABA group. In some cases, L, when optionally as a non-polymeric linker, does not encompass a polymer encompassed by the polymer moiety C, e.g., Y does not encompass a polyalkylene oxide (e.g., a PEG molecule).

Pharmaceutical Formulation

In some embodiments, the pharmaceutical formulations described herein are administered to a subject by multiple administration routes, including but not limited to, parenteral (e.g., intravenous, subcutaneous, intramuscular), oral, intranasal, buccal, rectal, or transdermal administration routes. In some instances, the pharmaceutical composition describe herein is formulated for parenteral (e.g., intravenous, subcutaneous, intramuscular, intra-arterial, intraperitoneal, intrathecal, intracerebral, intracerebroventricular, or intracranial) administration. In other instances, the pharmaceutical composition describe herein is formulated for oral administration. In still other instances, the pharmaceutical composition describe herein is formulated for intranasal administration.

In some embodiments, the pharmaceutical formulations include, but are not limited to, aqueous liquid dispersions, self-emulsifying dispersions, solid solutions, liposomal dispersions, aerosols, solid dosage forms, powders, immediate release formulations, controlled release formulations, fast melt formulations, tablets, capsules, pills, delayed release formulations, extended release formulations, pulsatile release formulations, multiparticulate formulations (e.g., nanoparticle formulations), and mixed immediate and controlled release formulations.

In some instances, the pharmaceutical formulation includes multiparticulate formulations. In some instances, the pharmaceutical formulation includes nanoparticle formulations. In some instances, nanoparticles comprise cMAP, cyclodextrin, or lipids. In some cases, nanoparticles comprise solid lipid nanoparticles, polymeric nanoparticles, self-emulsifying nanoparticles, liposomes, microemulsions, or micellar solutions. Additional exemplary nanoparticles include, but are not limited to, paramagnetic nanoparticles, superparamagnetic nanoparticles, metal nanoparticles, fullerene-like materials, inorganic nanotubes, dendrimers (such as with covalently attached metal chelates), nanofibers, nanohorns, nano-onions, nanorods, nanoropes and quantum dots. In some instances, a nanoparticle is a metal nanoparticle, e.g., a nanoparticle of scandium, titanium, vanadium, chromium, manganese, iron, cobalt, nickel, copper, zinc, yttrium, zirconium, niobium, molybdenum, ruthenium, rhodium, palladium, silver, cadmium, hafnium, tantalum, tungsten, rhenium, osmium, iridium, platinum, gold, gadolinium, aluminum, gallium, indium, tin, thallium, lead, bismuth, magnesium, calcium, strontium, barium, lithium, sodium, potassium, boron, silicon, phosphorus, germanium, arsenic, antimony, and combinations, alloys or oxides thereof.

In some instances, a nanoparticle includes a core or a core and a shell, as in a core-shell nanoparticle.

In some instances, a nanoparticle is further coated with molecules for attachment of functional elements (e.g., with one or more of a polynucleic acid molecule or binding moiety described herein). In some instances, a coating comprises chondroitin sulfate, dextran sulfate, carboxymethyl dextran, alginic acid, pectin, carragheenan, fucoidan, agaropectin, porphyran, karaya gum, gellan gum, xanthan gum, hyaluronic acids, glucosamine, galactosamine, chitin (or chitosan), polyglutamic acid, polyaspartic acid, lysozyme, cytochrome C, ribonuclease, trypsinogen, chymotrypsinogen, α-chymotrypsin, polylysine, polyarginine, histone, protamine, ovalbumin or dextrin or cyclodextrin. In some instances, a nanoparticle comprises a graphene-coated nanoparticle.

In some cases, a nanoparticle has at least one dimension of less than about 500 nm, 400 nm, 300 nm, 200 nm, or 100 nm.

In some instances, the nanoparticle formulation comprises paramagnetic nanoparticles, superparamagnetic nanoparticles, metal nanoparticles, fullerene-like materials, inorganic nanotubes, dendrimers (such as with covalently attached metal chelates), nanofibers, nanohorns, nano-onions, nanorods, nanoropes or quantum dots. In some instances, a polynucleic acid molecule or a binding moiety described herein is conjugated either directly or indirectly to the nanoparticle. In some instances, at least 1, 5, 10, 15, 20, 30, 40, 50, 60, 70, 80, 90, 100 or more polynucleic acid molecules or binding moieties described herein are conjugated either directly or indirectly to a nanoparticle.

In some embodiments, the pharmaceutical formulation comprise a delivery vector, e.g., a recombinant vector, the delivery of the polynucleic acid molecule into cells. In some instances, the recombinant vector is DNA plasmid. In other instances, the recombinant vector is a viral vector. Exemplary viral vectors include vectors derived from adeno-associated virus, retrovirus, adenovirus, or alphavirus. In some instances, the recombinant vectors capable of expressing the polynucleic acid molecules provide stable expression in target cells. In additional instances, viral vectors are used that provide for transient expression of polynucleic acid molecules.

In some embodiments, the pharmaceutical formulations include a carrier or carrier materials selected on the basis of compatibility with the composition disclosed herein, and the release profile properties of the desired dosage form. Exemplary carrier materials include, e.g., binders, suspending agents, disintegration agents, filling agents, surfactants, solubilizers, stabilizers, lubricants, wetting agents, diluents, and the like. Pharmaceutically compatible carrier materials include, but are not limited to, acacia, gelatin, colloidal silicon dioxide, calcium glycerophosphate, calcium lactate, maltodextrin, glycerine, magnesium silicate, polyvinylpyrrollidone (PVP), cholesterol, cholesterol esters, sodium caseinate, soy lecithin, taurocholic acid, phosphotidylcholine, sodium chloride, tricalcium phosphate, dipotassium phosphate, cellulose and cellulose conjugates, sugars sodium stearoyl lactylate, carrageenan, monoglyceride, diglyceride, pregelatinized starch, and the like. See, e.g., Remington: The Science and Practice of Pharmacy, Nineteenth Ed (Easton, Pa.: Mack Publishing Company, 1995); Hoover, John E., Remington's Pharmaceutical Sciences, Mack Publishing Co., Easton, Pa. 1975; Liberman, H. A. and Lachman, L., Eds., Pharmaceutical Dosage Forms, Marcel Decker, New York, N.Y., 1980; and Pharmaceutical Dosage Forms and Drug Delivery Systems, Seventh Ed. (Lippincott Williams & Wilkins 1999).

In some instances, the pharmaceutical formulations further include pH adjusting agents or buffering agents which include acids such as acetic, boric, citric, lactic, phosphoric and hydrochloric acids; bases such as sodium hydroxide, sodium phosphate, sodium borate, sodium citrate, sodium acetate, sodium lactate and tris-hydroxymethylaminomethane; and buffers such as citrate/dextrose, sodium bicarbonate and ammonium chloride. Such acids, bases and buffers are included in an amount required to maintain pH of the composition in an acceptable range.

In some instances, the pharmaceutical formulation includes one or more salts in an amount required to bring osmolality of the composition into an acceptable range. Such salts include those having sodium, potassium or ammonium cations and chloride, citrate, ascorbate, borate, phosphate, bicarbonate, sulfate, thiosulfate or bisulfite anions; suitable salts include sodium chloride, potassium chloride, sodium thiosulfate, sodium bisulfite and ammonium sulfate.

In some instances, the pharmaceutical formulations further include diluent which are used to stabilize compounds because they provide a more stable environment. Salts dissolved in buffered solutions (which also provide pH control or maintenance) are utilized as diluents in the art, including, but not limited to a phosphate buffered saline solution. In certain instances, diluents increase bulk of the composition to facilitate compression or create sufficient bulk for homogenous blend for capsule filling. Such compounds include e.g., lactose, starch, mannitol, sorbitol, dextrose, microcrystalline cellulose such as Avicel®; dibasic calcium phosphate, dicalcium phosphate dihydrate; tricalcium phosphate, calcium phosphate; anhydrous lactose, spray-dried lactose; pregelatinized starch, compressible sugar, such as Di-Pac® (Amstar); mannitol, hydroxypropylmethylcellulose, hydroxypropylmethylcellulose acetate stearate, sucrose-based diluents, confectioner's sugar; monobasic calcium sulfate monohydrate, calcium sulfate dihydrate; calcium lactate trihydrate, dextrates; hydrolyzed cereal solids, amylose; powdered cellulose, calcium carbonate; glycine, kaolin; mannitol, sodium chloride; inositol, bentonite, and the like.

In some cases, the pharmaceutical formulations include disintegration agents or disintegrants to facilitate the breakup or disintegration of a substance. The term “disintegrate” include both the dissolution and dispersion of the dosage form when contacted with gastrointestinal fluid. Examples of disintegration agents include a starch, e.g., a natural starch such as corn starch or potato starch, a pregelatinized starch such as National 1551 or Amijel®, or sodium starch glycolate such as Promogel® or Explotab®, a cellulose such as a wood product, methylcrystalline cellulose, e.g., Avicel®, Avicel® PH101, Avicel® PH102, Avicel® PH105, Elcema® P100, Emcocel®, Vivacel®, Ming Tia®, and Solka-Floc®, methylcellulose, croscarmellose, or a cross-linked cellulose, such as cross-linked sodium carboxymethylcellulose (Ac-Di-Sol®), cross-linked carboxymethylcellulose, or cross-linked croscarmellose, a cross-linked starch such as sodium starch glycolate, a cross-linked polymer such as crospovidone, a cross-linked polyvinylpyrrolidone, alginate such as alginic acid or a salt of alginic acid such as sodium alginate, a clay such as Veegum® HV (magnesium aluminum silicate), a gum such as agar, guar, locust bean, Karaya, pectin, or tragacanth, sodium starch glycolate, bentonite, a natural sponge, a surfactant, a resin such as a cation-exchange resin, citrus pulp, sodium lauryl sulfate, sodium lauryl sulfate in combination starch, and the like.

In some instances, the pharmaceutical formulations include filling agents such as lactose, calcium carbonate, calcium phosphate, dibasic calcium phosphate, calcium sulfate, microcrystalline cellulose, cellulose powder, dextrose, dextrates, dextran, starches, pregelatinized starch, sucrose, xylitol, lactitol, mannitol, sorbitol, sodium chloride, polyethylene glycol, and the like.

Lubricants and glidants are also optionally included in the pharmaceutical formulations described herein for preventing, reducing or inhibiting adhesion or friction of materials. Exemplary lubricants include, e.g., stearic acid, calcium hydroxide, talc, sodium stearyl fumerate, a hydrocarbon such as mineral oil, or hydrogenated vegetable oil such as hydrogenated soybean oil (Sterotex®), higher fatty acids and their alkali-metal and alkaline earth metal salts, such as aluminum, calcium, magnesium, zinc, stearic acid, sodium stearates, glycerol, talc, waxes, Stearowet®, boric acid, sodium benzoate, sodium acetate, sodium chloride, leucine, a polyethylene glycol (e.g., PEG-4000) or a methoxypolyethylene glycol such as Carbowax™ sodium oleate, sodium benzoate, glyceryl behenate, polyethylene glycol, magnesium or sodium lauryl sulfate, colloidal silica such as Syloid™, Cab-O-Sil®, a starch such as corn starch, silicone oil, a surfactant, and the like.

Plasticizers include compounds used to soften the microencapsulation material or film coatings to make them less brittle. Suitable plasticizers include, e.g., polyethylene glycols such as PEG 300, PEG 400, PEG 600, PEG 1450, PEG 3350, and PEG 800, stearic acid, propylene glycol, oleic acid, triethyl cellulose and triacetin. Plasticizers also function as dispersing agents or wetting agents.

Solubilizers include compounds such as triacetin, triethylcitrate, ethyl oleate, ethyl caprylate, sodium lauryl sulfate, sodium doccusate, vitamin E TPGS, dimethylacetamide, N-methylpyrrolidone, N-hydroxyethylpyrrolidone, polyvinylpyrrolidone, hydroxypropylmethyl cellulose, hydroxypropyl cyclodextrins, ethanol, n-butanol, isopropyl alcohol, cholesterol, bile salts, polyethylene glycol 200-600, glycofurol, transcutol, propylene glycol, and dimethyl isosorbide and the like.

Stabilizers include compounds such as any antioxidation agents, buffers, acids, preservatives and the like.

Suspending agents include compounds such as polyvinylpyrrolidone, e.g., polyvinylpyrrolidone K12, polyvinylpyrrolidone K17, polyvinylpyrrolidone K25, or polyvinylpyrrolidone K30, vinyl pyrrolidone/vinyl acetate copolymer (S630), polyethylene glycol, e.g., the polyethylene glycol has a molecular weight of about 300 to about 6000, or about 3350 to about 4000, or about 7000 to about 5400, sodium carboxymethylcellulose, methylcellulose, hydroxypropylmethylcellulose, hydroxymethylcellulose acetate stearate, polysorbate-80, hydroxyethylcellulose, sodium alginate, gums, such as, e.g., gum tragacanth and gum acacia, guar gum, xanthans, including xanthan gum, sugars, cellulosics, such as, e.g., sodium carboxymethylcellulose, methylcellulose, sodium carboxymethylcellulose, hydroxypropylmethylcellulose, hydroxyethylcellulose, polysorbate-80, sodium alginate, polyethoxylated sorbitan monolaurate, polyethoxylated sorbitan monolaurate, povidone and the like.

Surfactants include compounds such as sodium lauryl sulfate, sodium docusate, Tween 60 or 80, triacetin, vitamin E TPGS, sorbitan monooleate, polyoxyethylene sorbitan monooleate, polysorbates, polaxomers, bile salts, glyceryl monostearate, copolymers of ethylene oxide and propylene oxide, e.g., Pluronic® (BASF), and the like. Additional surfactants include polyoxyethylene fatty acid glycerides and vegetable oils, e.g., polyoxyethylene (60) hydrogenated castor oil; and polyoxyethylene alkylethers and alkylphenyl ethers, e.g., octoxynol 10, octoxynol 40. Sometimes, surfactants is included to enhance physical stability or for other purposes.

Viscosity enhancing agents include, e.g., methyl cellulose, xanthan gum, carboxymethyl cellulose, hydroxypropyl cellulose, hydroxypropylmethyl cellulose, hydroxypropylmethyl cellulose acetate stearate, hydroxypropylmethyl cellulose phthalate, carbomer, polyvinyl alcohol, alginates, acacia, chitosans and combinations thereof.

Wetting agents include compounds such as oleic acid, glyceryl monostearate, sorbitan monooleate, sorbitan monolaurate, triethanolamine oleate, polyoxyethylene sorbitan monooleate, polyoxyethylene sorbitan monolaurate, sodium docusate, sodium oleate, sodium lauryl sulfate, sodium doccusate, triacetin, Tween 80, vitamin E TPGS, ammonium salts and the like.

Therapeutic Regimens

In some embodiments, the pharmaceutical compositions described herein are administered for therapeutic applications. In some embodiments, the pharmaceutical composition is administered once per day, twice per day, three times per day or more. The pharmaceutical composition is administered daily, every day, every alternate day, five days a week, once a week, every other week, two weeks per month, three weeks per month, once a month, twice a month, three times per month, or more. The pharmaceutical composition is administered for at least 1 month, 2 months, 3 months, 4 months, 5 months, 6 months, 7 months, 8 months, 9 months, 10 months, 11 months, 12 months, 18 months, 2 years, 3 years, or more.

In some embodiments, one or more pharmaceutical compositions are administered simultaneously, sequentially, or at an interval period of time. In some embodiments, one or more pharmaceutical compositions are administered simultaneously. In some cases, one or more pharmaceutical compositions are administered sequentially. In additional cases, one or more pharmaceutical compositions are administered at an interval period of time (e.g., the first administration of a first pharmaceutical composition is on day one followed by an interval of at least 1, 2, 3, 4, 5, or more days prior to the administration of at least a second pharmaceutical composition).

In some embodiments, two or more different pharmaceutical compositions are coadministered. In some instances, the two or more different pharmaceutical compositions are coadministered simultaneously. In some cases, the two or more different pharmaceutical compositions are coadministered sequentially without a gap of time between administrations. In other cases, the two or more different pharmaceutical compositions are coadministered sequentially with a gap of about 0.5 hour, 1 hour, 2 hour, 3 hour, 12 hours, 1 day, 2 days, or more between administrations.

In the case wherein the patient's status does improve, upon the doctor's discretion the administration of the composition is given continuously; alternatively, the dose of the composition being administered is temporarily reduced or temporarily suspended for a certain length of time (i.e., a “drug holiday”). In some instances, the length of the drug holiday varies between 2 days and 1 year, including by way of example only, 2 days, 3 days, 4 days, 5 days, 6 days, 7 days, 10 days, 12 days, 15 days, 20 days, 28 days, 35 days, 50 days, 70 days, 100 days, 120 days, 150 days, 180 days, 200 days, 250 days, 280 days, 300 days, 320 days, 350 days, or 365 days. The dose reduction during a drug holiday is from 10%-100%, including, by way of example only, 10%, 15%, 20%, 25%, 30%, 35%, 40%, 45%, 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, or 100%.

Once improvement of the patient's conditions has occurred, a maintenance dose is administered if necessary. Subsequently, the dosage or the frequency of administration, or both, can be reduced, as a function of the symptoms, to a level at which the improved disease, disorder or condition is retained.

In some embodiments, the amount of a given agent that correspond to such an amount varies depending upon factors such as the particular compound, the severity of the disease, the identity (e.g., weight) of the subject or host in need of treatment, but nevertheless is routinely determined in a manner known in the art according to the particular circumstances surrounding the case, including, e.g., the specific agent being administered, the route of administration, and the subject or host being treated. In some instances, the desired dose is conveniently presented in a single dose or as divided doses administered simultaneously (or over a short period of time) or at appropriate intervals, for example as two, three, four or more sub-doses per day.

The foregoing ranges are merely suggestive, as the number of variables in regard to an individual treatment regime is large, and considerable excursions from these recommended values are not uncommon. Such dosages is altered depending on a number of variables, not limited to the activity of the compound used, the disease or condition to be treated, the mode of administration, the requirements of the individual subject, the severity of the disease or condition being treated, and the judgment of the practitioner.

In some embodiments, toxicity and therapeutic efficacy of such therapeutic regimens are determined by standard pharmaceutical procedures in cell cultures or experimental animals, including, but not limited to, the determination of the LD50 (the dose lethal to 50% of the population) and the ED50 (the dose therapeutically effective in 50% of the population). The dose ratio between the toxic and therapeutic effects is the therapeutic index and it is expressed as the ratio between LD50 and ED50. Compounds exhibiting high therapeutic indices are preferred. The data obtained from cell culture assays and animal studies are used in formulating a range of dosage for use in human. The dosage of such compounds lies preferably within a range of circulating concentrations that include the ED50 with minimal toxicity. The dosage varies within this range depending upon the dosage form employed and the route of administration utilized.

Kits/Article of Manufacture

Disclosed herein, in certain embodiments, are kits and articles of manufacture for use with one or more of the compositions and methods described herein. Such kits include a carrier, package, or container that is compartmentalized to receive one or more containers such as vials, tubes, and the like, each of the container(s) comprising one of the separate elements to be used in a method described herein. Suitable containers include, for example, bottles, vials, syringes, and test tubes. In one embodiment, the containers are formed from a variety of materials such as glass or plastic.

The articles of manufacture provided herein contain packaging materials. Examples of pharmaceutical packaging materials include, but are not limited to, blister packs, bottles, tubes, bags, containers, bottles, and any packaging material suitable for a selected formulation and intended mode of administration and treatment.

For example, the container(s) include target nucleic acid molecule described herein. Such kits optionally include an identifying description or label or instructions relating to its use in the methods described herein.

A kit typically includes labels listing contents and/or instructions for use, and package inserts with instructions for use. A set of instructions will also typically be included.

In one embodiment, a label is on or associated with the container. In one embodiment, a label is on a container when letters, numbers or other characters forming the label are attached, molded or etched into the container itself; a label is associated with a container when it is present within a receptacle or carrier that also holds the container, e.g., as a package insert. In one embodiment, a label is used to indicate that the contents are to be used for a specific therapeutic application. The label also indicates directions for use of the contents, such as in the methods described herein.

In certain embodiments, the pharmaceutical compositions are presented in a pack or dispenser device which contains one or more unit dosage forms containing a compound provided herein. The pack, for example, contains metal or plastic foil, such as a blister pack. In one embodiment, the pack or dispenser device is accompanied by instructions for administration. In one embodiment, the pack or dispenser is also accompanied with a notice associated with the container in form prescribed by a governmental agency regulating the manufacture, use, or sale of pharmaceuticals, which notice is reflective of approval by the agency of the form of the drug for human or veterinary administration. Such notice, for example, is the labeling approved by the U.S. Food and Drug Administration for prescription drugs, or the approved product insert. In one embodiment, compositions containing a compound provided herein formulated in a compatible pharmaceutical carrier are also prepared, placed in an appropriate container, and labeled for treatment of an indicated condition.

Certain Terminology

Unless defined otherwise, all technical and scientific terms used herein have the same meaning as is commonly understood by one of skill in the art to which the claimed subject matter belongs. It is to be understood that the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of any subject matter claimed. In this application, the use of the singular includes the plural unless specifically stated otherwise. It must be noted that, as used in the specification and the appended claims, the singular forms “a,” “an” and “the” include plural referents unless the context clearly dictates otherwise. In this application, the use of “or” means “and/or” unless stated otherwise. Furthermore, use of the term “including” as well as other forms, such as “include”, “includes,” and “included,” is not limiting.

As used herein, ranges and amounts can be expressed as “about” a particular value or range. About also includes the exact amount. Hence “about 5 μL” means “about 5 μL” and also “5 μL.” Generally, the term “about” includes an amount that would be expected to be within experimental error.

The section headings used herein are for organizational purposes only and are not to be construed as limiting the subject matter described.

As used herein, the terms “individual(s)”, “subject(s)” and “patient(s)” mean any mammal. In some embodiments, the mammal is a human. In some embodiments, the mammal is a non-human. None of the terms require or are limited to situations characterized by the supervision (e.g. constant or intermittent) of a health care worker (e.g. a doctor, a registered nurse, a nurse practitioner, a physician's assistant, an orderly or a hospice worker).

As used herein the terms “DMD,” “DMD gene,” and equivalents thereof refer to the DMD gene that encodes for the protein dystrophin. In addition, the terms “DMD” and “DMD gene” are used interchangeable, and both terms refer to the dystrophin gene.

EXAMPLES

These examples are provided for illustrative purposes only and not to limit the scope of the claims provided herein.

Example 1. Antisense Oligonucleotide Sequences and Synthesis

Phosphorodiamidate morpholino oligomers (PMO), phosphorothioate antisense oligonucleotides (PS ASO), and antisense oligonucleotides (ASOs) were synthesized.

The PMO sequence was 5′GGCCAAACCTCGGCTTACCTGAAAT3′ Primary amine (SEQ ID NO: 28) and can be seen in FIG. 1 with end nucleotides expanded. The PMO contains a C3-NH₂ conjugation handle at the 3′ end of the molecule for conjugation. PMOs were fully assembled on solid phase using standard solid phase synthesis protocols and purified over HPLC.

The PS ASO sequence was Amine-C6-GGCCAAACCUCGGCUUACCU (SEQ ID NO: 29) and can be seen in FIGS. 2A-2B with end nucleotides expanded. The structure of the PS ASO comprised a phosphate backbone that was 100% phosphorothioate linkages and all the ribose sugars contained a 2′ 2′OMe modification. The PS ASO also contained a C6-NH2 conjugation handle at the 5′ end of the molecule for conjugation. The PS ASOs were fully assembled on the solid phase using standard solid phase phosphoramidite chemistry and purified over HPLC.

ASOs were fully assembled on the solid phase using standard solid phase phosphoramidite chemistry and purified over HPLC. ASOs contained a C6-NH2 conjugation handle at the 5′ end of the molecule for conjugation.

Example 2. Detection of DMD Exon Skipping

Methods for Determining DMD Exon 23 Skipping in Differentiated C1C12 Cells

Mouse myoblast C2C12 cells were plated at 50,000-100,000/well in 24-well plates in 0.5 mL 10% FBS RPMI 1640 media and incubated at 37° C. with 5% CO₂ overnight. On the second day, cells were switched to differentiation media (2% horse serum RPMI 1640 and 1 μM insulin) and incubated for 3-5 days. Following incubation, samples were added and incubated for 24 hours. After the sample treatment, 1 mL of fresh media (with no compounds) was changed every day for 2 more days. At 72 hours after the start of treatments, cells were harvested. RNAs were isolated using InviTrap RNA Cell HTS 96 Kit (B-Bridge International #7061300400) and reverse transcribed using High Capacity cDNA Reverse transcription Kit (ThermoFisher #4368813). PCR reactions were performed using DreamTaq™ PCR Mastermix (ThermoFisher #K1072). The primary PCR used primers in exon 20 (Ex20F 5′-CAGAATTCTGCCAATTGCTGAG) (SEQ ID NO: 30) and exon 26 (Ex26R 5′-TTCTTCAGCTTGTGTCATCC) (SEQ ID NO: 31) to amplify both skipped and unskipped molecules using the protocol in Table 2.

TABLE 2 PCR Protocol Hot Start 95° C. for 2 minutes Denaturation 95° C. for 0.5 minute Annealing of primers 50° C. for 0.5 minute Primer extension 72° C. for 1 minute Final extension 72° C. for 5 minutes Number of Cycles 10

For the nested PCR, primary PCR reactions were diluted with water 100×, and 5 μl was used for nested PCR reaction (50 μl total reaction volume). Nested PCR used primers in exon 20 (Ex20F2: 5′-ACCCAGTCTACCACCCTATC) (SEQ ID NO: 32) and exon 25 (Ex25R: 5′-CTCTTTATCTTCTGCCCACCTT) (SEQ ID NO: 33) to amplify both skipped and unskipped molecules using the protocol in Table 3.

TABLE 3 Nested PCR Protocol Hot Start 95° C. for 2 minutes Denaturation 95° C. for 0.5 minute Annealing of primers 50° C. for 0.5 minute Primer extension 72° C. for 1 minute Final extension 72° C. for 5 minutes Number of Cycles 35

PCR reactions were analyzed using 4% TAE agarose gels. The wild-type (WT) DMD product had an expected size of 788 base pairs and the skipped DMD 423 of 575 base pairs.

Animals

All animal studies were conducted following protocols in accordance with the Institutional Animal Care and Use Committee (IACUC) at Explora BioLabs, which adhere to the regulations outlined in the USDA Animal Welfare Act as well as the “Guide for the Care and Use of Laboratory Animals” (National Research Council publication, 8th Ed., revised in 2011). All mice were obtained from either Charles River Laboratories or Harlan Laboratories.

In Vivo Mouse Model

WT CD-1 mice (4-6 weeks old) were dosed via intravenous (iv) injection with the indicated antisense conjugates (ASCs) and doses. The “naked” PMO or ASO were dosed via intramuscular injection at the indicated doses. After 4, 7, or 14 days, heart and gastrocnemius muscle tissues were harvested and snap-frozen in liquid nitrogen. RNAs were isolated with Trizol and RNeasy Plus 96 Kit (Qiagen, #74192) and reversed transcribed using High Capacity cDNA Reverse transcription Kit (ThermoFisher #4368813). Nested PCR reactions were performed as described. PCR reactions were analyzed in 4% (or 1%) TAE agarose gels which were quantitated by densitometry.

To confirm exon 23 skipping in treated mice, DNA fragments were isolated from the 4% agarose gels and sequenced.

To quantitatively determine the skipped DMD mRNA copy number, qPCR primer/probe sets were designed to quantify skipped and WT DMD mRNA (FIG. 3). qPCR quantification standards were designed and produced via PCR using designed PCR primers as seen in Table 4. For the qPCR standard for WT and DMD, following PCR a 733 base pair fragment was isolated from the agarose gel. For qPCR standard for skipped DMA, the nested primers were used.

The amplification efficiency of the qPCR primer/probes were determined to be within 10% of expected efficiency. qPCR reactions were performed in QuantStudio 7 and Taqman™ PCR Universal Mastermix II (ThermoFisher #4440041) according to manufacturer's instructions.

TABLE 4 SEQ ID NO Primer/Probe Sequence DMD Δ-23, 34 Forward 5′ GCGCTATCAGGAGACAATGAG for Ex23 Primer skipping 35 Reverse 5′ GTTTTTATGTGATTCTGTAATTTCCC Primer 36 Probe 5′ CTCTCTGTACCTTATCTTAGTGTT DMD Ex22- 37 Forward 5′ TGGAGGAGAGACTCGGGAAA 23, for WT Primer DMD only 38 Reverse 5′ TTGAAGCCATTTTGTTGCTCTTT Primer 39 Probe 5′ ACAGGCTCTGCAAAGT DMD Ex20- 40 Forward 5′ AACAGATGACAACTACTGCCGAAA 21, for All Primer DMD 41 Reverse 5′ TTGGCTCTGATAGGGTGGTAGAC Primer 42 Probe 5′ CTTGTTGAAAACCC qPCR 43 Forward 5′ TGAGGGTGTTAATGCTGAAAGTA standard for Primer WT and all 44 Reverse 5′ CACCAACTGGGAGGAAAGTT DMD Primer

Example 3: Conjugate Synthesis

Analytical and Purification Methods

Analytical and purification methods were performed according to Tables 5-11.

TABLE 5 Size exclusion chromatography (SEC) methods Size Exclusion Chromatography (SEC) Method Column Mobile Phase Flow Rate method 1 TOSOH Biosciences, 150 mM 1.0 mL/minute TSKgelG3000SW phosphate for 20 minutes XL, 7.8 X 300 mm, 5 buffer μM method 2 TOSOH Biosciences, PBS pH 7.4 1.0 mL/minute TSKgelG3000SW, for 180 minutes 21.5 X 600 mm, 5 μM

TABLE 6 Hydrophobic interaction chromatography (HIC) method 1 Gradient Column % % Column Solvent Volume A B GE, HiScreen Solvent A: 50 mM phosphate buffer, 1.00 95 5 Butyl HP, 0.8M Ammonium Sulfate, pH 7.0 30 0 100 4.7 mL Solvent B: 80% 50 mM phosphate 5 0 100 buffer, 20% IPA, pH 7.0 Flow Rate: 1.0 mL/minute

TABLE 7 Hydrophobic interaction chromatography (HIC) method 2 Gradient % % Column Solvent Time A B Thermo Scientific, Solvent A: 100 mM 0.00 100 0 MAbPac HIC-20, phosphate buffer, 1.8M 4.6 mm ID X 10 Ammonium Sulfate, pH 7.0 2.00 100 0 cm, 5 um Solvent B: 80% 100 mM 22.00 0 100 phosphate buffer, 20% IPA, pH 7.0 25.00 0 100 Flow Rate: 0.7 mL/minute 26.00 100 0 30.00 100 0

TABLE 8 Hydrophobic interaction chromatography (HIC) method 3 Gradient Column % % Column Solvent Volume A B GE, HiScreen Solvent A: 50 mM phosphate buffer, 1 100 0 Butyl HP, 0.8M Ammonium Sulfate, pH 7.0 25 0 80 4.7 mL Solvent B: 80% 50 mM phosphate 1 0 100 buffer, 20% IPA, pH 7.0 2 0 100 Flow Rate: 1.0 mL/minute

TABLE 9 Hydrophobic interaction chromatography (HIC) method 4 Gradient % % Column Solvent Time A B Thermo Solvent A: 100 mM phosphate buffer, 0.00 100 0 Scientific, 1.8M Ammonium Sulfate, pH 7.0 5.00 100 0 MAbPac Solvent B: 80% 100 mM phosphate 20.00 0 100 HIC-20, 4.6 buffer, 20% IPA, pH 7.0 25.00 0 100 mm ID X 10 Flow Rate: 0.5 mL/minute 26.00 100 0 cm, 5 um 30.00 100 0

TABLE 10 Strong anion exchange chromatography (SAX) method 1 Gradient Column % % Column Solvent Volume A B Tosoh Bioscience, Solvent A: 20 mM TRIS buffer, 0.5 100 0 TSKGel SuperQ- pH 8.0; 5PW, 21.5 mm ID Solvent B: 20 mM TRIS, 0.5 80 20 X 15 cm, 13 um 1.5 M NaCl, pH 8.0 17 20 80 Flow Rate: 6.0 mL/minute 0.5 0 100 0.5 0 100

TABLE 11 Strong anion exchange chromatography (SAX) method 2 Gradient % % Column Solvent Time A B Thermo Scientific, Solvent A: 80% 10 mM TRIS pH 8, 0.0 90 10 ProPac^(Tm) SAX- 20% ethanol 3.00 90 10 10, Bio LC^(TM), Solvent B: 80% 10 mM TRIS pH 8, 17.00 0 100 4 X 250 mm 20% ethanol, 1.5M NaCl 21.00 0 100 Flow Rate: 0.75 mL/minute 22.00 90 10 25.00 90 10

Anti-Transferrin Receptor Antibody

Anti-mouse transferrin receptor antibody or anti-CD71 mAb that was used was a rat IgG2a subclass monoclonal antibody that binds mouse CD71 or mouse transferrin receptor 1 (mTfR1). The antibody was produced by BioXcell and it is commercially available (Catalog #BE0175).

Anti-CD71 Antibody Morpholino Antisense Oligonucleotide Conjugate (Anti-CD71 mAb-PMO)

Anti-CD71 mAb-PMO Conjugation

Anti-CD71 antibody (10 mg/mL) in borate buffer (25 mM sodium tetraborate, 25 mM NaCl, 1 mM Diethylene triamine pentaacetic acid, pH 8.0) was reduced by adding 4 equivalents of tris(2-carboxyethyl)phosphine (TCEP) in water and incubating at 37° C. for 4 hours. 4(N-Maleimidomethyl)cyclohexanecarboxylic acid N-hydroxysuccinimide ester (SMCC) was coupled to the primary amine on the 3′ end of the phosphorodiamidate morpholino oligomer (PMO) by incubating the PMO (50 mg/mL) in DMSO with 10 equivalents of SMCC (10 mg/mL) in DMSO for one hour. Unconjugated SMCC was removed by ultrafiltration using Amicon Ultra-15 centrifugal filter units with a MWCO of 3 kDa. The PMO-SMCC was washed three times with acetate buffer (10 mM sodium acetate, pH 6.0) and used immediately. The reduced antibody was mixed with 2.25 equivalents of PMO-SMCC and incubated overnight at 4° C. The pH of the reaction mixture was then reduced to 7.5, and 8 equivalents of N-Ethylmaleimide was added to the mixture at room temperature for 30 minutes to quench unreacted cysteines. Analysis of the reaction mixture by hydrophobic interaction chromatography (HIC) method 2 showed antibody-PMO conjugates along with unreacted antibody and PMO (FIG. 4). FIG. 4 shows a chromatogram of anti-CD71 mAb-PMO reaction mixture produced with HIC method 2 showing free antibody peak (1), free PMO (2), DAR 1 (3), DAR 2 (4), DAR 3 (5), DAR>3 (6). “DAR” refers to a drug-to-antibody ratio. The number in parentheses refers to the peak in the chromatogram.

Purification

The reaction mixture was purified with an AKTA Explorer FPLC using HIC method 1. Fractions containing conjugates with a drug to antibody ratio of one (DAR 1) and two (DAR 2) were combined and concentrated with Amicon Ultra-15 centrifugal filter units with a MWCO of 50 kDa separately from conjugates with a DAR greater than 2. Concentrated conjugates were buffer exchanged with PBS (pH 7.4) using Amicon Ultra-15 centrifugal filter units prior to analysis.

Analysis of the Purified Conjugate

The isolated conjugates were characterized by size exclusion chromatography (SEC) and HIC. SEC method 1 was used to confirm the absence of high molecular weight aggregates and unconjugated PMOs (FIGS. 5A-5C). FIG. 5A shows a chromatogram of anti-CD71 mAb produced using SEC method 1. FIG. 5B shows a chromatogram of anti-CD71 mAb-PMO DAR 1,2 produced using SEC method 1. FIG. 5C shows a chromatogram of anti-CD71 mAb-PMO DAR greater than 2 produced using SEC method 1. “DAR” refers to a drug-to-antibody ratio.

The purity of the conjugate was assessed by analytical HPLC using HIC method 2 (FIGS. 6A-6C). FIG. 6A shows a chromatogram of anti-CD71 mAb produced using HIC method 2. FIG. 6B shows a chromatogram of purified anti-CD71 mAb-PMO DAR 1,2 conjugate produced using HIC method 2. FIG. 6C shows a chromatogram of purified anti-CD71 mAb-PMO DAR>2 conjugate produced using HIC method 2. The 260/280 nm UV absorbance ratio of each sample was compared to a standard curve of known ratios of PMO and antibody to confirm DAR. The DAR 1,2 sample had an average DAR of ˜1.6 while the DAR greater than 2 sample had an average DAR of ˜3.7. “DAR” refers to a drug-to-antibody ratio.

Anti-CD71 Fab Morpholino Antisense Oligonucleotide Conjugate (Anti-CD71 Fab-PMO)

Antibody Digestion with Pepsin

Anti-CD71 antibody (5 mg/mL) in 20 mM acetate buffer (pH 4.0) was incubated with immobilized pepsin for 3 hours at 37° C. The resin was removed and the reaction mixture was washed with PBS (pH 7.4) using Amicon Ultra-15 centrifugal filter units with a MWCO of 30 kDa. The retentate was collected and purified using size exclusion chromatography (SEC) method 2 to isolate the F(ab′)2 fragment.

Anti-CD71 (Fab)-PMO Conjugation

The F(ab′)2 fragment (15 mg/mL) in borate buffer (pH 8.0) was reduced by adding 10 equivalents of TCEP in water and incubating at 37° C. for 2 hours. SMCC was added to the primary amine on the 3′ end of the PMO by incubating the PMO (50 mg/mL) in DMSO with 10 equivalents of SMCC (10 mg/mL) in DMSO for 1 hour. Unconjugated SMCC was removed by ultrafiltration using Amicon Ultra-15 centrifugal filter units with a MWCO of 3 kDa. The PMO-SMCC was washed three times with acetate buffer (pH 6.0) and used immediately. The reduced F(ab′) fragment (Fab) was buffer exchanged into borate buffer (pH 8.0) using Amicon Ultra-15 Centrifugal Filter Units with a MWCO of 10 kDa, and 1.75 equivalents of PMO-SMCC was added and incubated overnight at 4° C. The pH of the reaction mixture was then reduced to 7.5, and 6 equivalents of N-Ethylmaleimide was added to the mixture at room temperature for 30 minutes to quench unreacted cysteines. Analysis of the reaction mixture by hydrophobic interaction chromatography (HIC) method 3 showed anti-CD71 (Fab)-PMO conjugates along with unreacted Fab (FIG. 7A). FIG. 7A shows a chromatogram of FPLC purification of anti-CD71 Fab-PMO using HIC method 3.

Purification

The reaction mixture was purified with an AKTA Explorer FPLC using HIC method 3.

Fractions containing conjugates with a DAR of one, two and three were combined and concentrated separately. Concentrated conjugates were buffer exchanged with PBS (pH 7.4) using Amicon Ultra-15 centrifugal filter units with a MWCO of 10 kDa prior to analysis.

Analysis of the Purified Conjugate

The isolated conjugates were characterized by SEC, and HIC. SEC method 1 was used to confirm the absence of high molecular weight aggregates and unconjugated PMO. See FIGS. 7B-7E. FIG. 7B shows a chromatogram of anti-CD71 Fab produced using SEC method 1. FIG. 7C shows a chromatogram of anti-CD71 Fab-PMO DAR 1 conjugate produced using SEC method 1. FIG. 7D shows a chromatogram of anti-CD71 Fab-PMO DAR 2 conjugate produced using SEC method 1. FIG. 7E shows a chromatogram of anti-CD71 Fab-PMO DAR 3 conjugate produced using SEC method 1. The purity of the conjugate was assessed by analytical HPLC using HIC method 4. See FIGS. 7F-7I. FIG. 7F shows a chromatogram of anti-CD71 Fab produced using HIC method 4. FIG. 7G shows a chromatogram of anti-CD71 Fab-PMO DAR 1 conjugate produced using HIC method 4. FIG. 7H shows a chromatogram of anti-CD71 Fab-PMO DAR 2 conjugate produced using HIC method 4. FIG. 7I shows a chromatogram of anti-CD71 Fab-PMO DAR 3 conjugate produced using HIC method 4. “DAR” refers to drug-to-antibody ratio. The 260/280 nm UV absorbance ratio of each sample was compared to a standard curve of known ratios of PMO and Fab to confirm DAR.

Anti-CD71 Antibody Phosphorothioate Antisense Oligonucleotide Conjugate (Anti-CD71 mAb-PS ASO)

Anti-CD71 mAb-PS ASO

Anti-CD71 antibody (10 mg/mL) in borate buffer (pH 8.0) was reduced by adding 4 equivalents of TCEP in water and incubating at 37° C. for 4 hours. 4(N-Maleimidomethyl)cyclohexanecarboxylic acid N-hydroxysuccinimide ester (SMCC) was added to the primary amine on the 5′ end of the PS-ASO by incubating the PS ASO (50 mg/mL) in 1:1 mixture of 250 mM PB (pH 7.5) and DMSO with 10 equivalents of SMCC (10 mg/mL) in DMSO for 1 hour. Unconjugated SMCC was removed by ultrafiltration using Amicon Ultra-15 centrifugal filter units with a MWCO of 3 kDa. The PS ASO-SMCC was washed three times with acetate buffer (pH 6.0) and used immediately. The reduced antibody was mixed with 1.7 equivalents of PS ASO-SMCC and incubated overnight at 4° C. The pH of the reaction mixture was then reduced to 7.4, and 8 equivalents of N-Ethylmaleimide was added to the mixture at room temperature for 30 minutes to quench unreacted cysteines. Analysis of the reaction mixture by strong anion exchange chromatography (SAX) method 2 showed antibody-PS ASO conjugates along with unreacted antibody and ASO (FIG. 8A). FIG. 8A shows a chromatogram of anti-CD71 mAb-PS ASO reaction mixture produced with SAX method 2 showing free antibody peak (1), free PS ASO (5), DAR 1 (2), DAR 2 (3), DAR>2 (4). “DAR” refers to a drug-to-antibody ratio. The number in parentheses refers to the peak.

Purification

The reaction mixture was purified with an AKTA Explorer FPLC using SAX method 1. Fractions containing conjugates with a drug-to-antibody ratio (DAR) of one, two and three were combined and concentrated separately and buffer exchanged with PBS (pH 7.4) using Amicon Ultra-15 centrifugal filter units with a MWCO of 50 kDa prior to analysis.

Analysis of the Purified Conjugate

The isolated conjugates were characterized by size exclusion chromatography (SEC) and SAX. Size exclusion chromatography method 1 was used to confirm the absence of high molecular weight aggregates and unconjugated ASO. See FIGS. 8B-8E. FIG. 8B shows a chromatogram of anti-CD71 mAb produced using SEC method 1. FIG. 8C shows a chromatogram of anti-CD71 mAb-PS ASO DAR 1 conjugate produced using SEC method 1. FIG. 8D shows a chromatogram of anti-CD71 mAb-PS ASO DAR 2 conjugate produced using SEC method 1. FIG. 8E shows a chromatogram of anti-CD71 mAb-PS ASO DAR 3 conjugate produced using SEC method 1. The purity of the conjugate was assessed by analytical HPLC using SAX method 2. See FIGS. 8F-8H. FIG. 8F shows a chromatogram of anti-CD71 mAb-PS ASO DAR 1 conjugate produced using SAX method 2. FIG. 8G shows a chromatogram of anti-CD71 mAb-PS ASO DAR 2 conjugate produced using SAX method 2. FIG. 8H shows a chromatogram of anti-CD71 mAb-PS ASO DAR 3 conjugate produced using SAX method 2. The 260/280 nm UV absorbance ratio of each sample was compared to a standard curve of known ratios of ASO and antibody to confirm drug-to-antibody ratio (DAR).

Example 4: In Vitro Activity of Anti-CD71 mAb-PMO Conjugate

The anti-CD71 mAb-PMO conjugate was made and characterized as described in Example 3. The conjugate was assessed for its ability to mediate exon skipping in vitro in differentiated C2C12 cells using nested PCR using methods similar to Example 2. Briefly, the potency of “naked” morpholino ASO (“PMO”) was compared to an anti-CD71 mAb-PMO conjugate at multiple concentrations with the relevant vehicle controls. Controls included vehicle (“Veh”), scramble morpholino at 50 uM (“Scr50”), and no antibody (“Neg-Ab”). The concentrations of PMO used included 50 uM, 1 uM, and 0.02 uM. The concentrations of anti-CD71 mAB-PMO DAR 1,2 used included 200 nM, 20 nM, and 2 nM. “DAR” refers to drug-to-antibody ratio.

Following cDNA synthesis, two rounds of PCR amplification (primary and nested PCR) were used to detect exon-skipping. PCR reactions were analyzed in a 4% TAE agarose gel (FIG. 9).

Referring to FIG. 9, anti-CD71 mAb-PMO conjugate produced measurable exon 23 skipping in differentiated C2C12 cells and lower concentrations than the “naked” PMO control. The wild-type product had an expected size of 788 base pairs and the skipped DMD 423 of 575 base pairs.

A second experiment included an anti-CD71 Fab-PMO conjugate and a PMO targeted with an anti-EGFR (“Z-PMO”) as a negative control (FIG. 10). The concentrations of PMO used included 10 uM and 2 uM. The concentrations of anti-CD71 mAb-PMO used included 0.2 uM and 0.04 uM. Anti-CD71 mAb-PMO had a DAR of 2. Z-PMO was used at a concentration of 0.2 uM and had a DAR of 2. Concentrations of anti-CD71 Fab-PMO included 0.6 uM and 0.12 uM. DAR of 1, 2, and 3 for anti-CD71 mAb-PMO at 0.6 uM and 0.12 uM were assayed.

Referring to FIG. 10, Receptor mediated uptake utilizing the transferrin receptor, the anti-CD71 mAb-PMO, and anti-CD71 Fab-PMO conjugates resulted in measurable exon 23 skipping in C2C12 cells and lower concentrations than the “naked” PMO control. There was no measurable exon 23 skipping from the Z-PMO at the concentration tested, which produced skipping from the anti-CD71 conjugates.

Example 5. In Vitro Activity of Anti-CD71-ASO mAb PS Conjugate

The anti-CD71 mAb-PS ASO conjugate was made and characterized as described in Example 3. The conjugate was assessed for its ability to mediate exon skipping in vitro in differentiated C2C12 cells using nested PCR using similar methods as described in Example 2. Briefly, the potency of “naked” phosphorothioate ASO (PS ASO) was compared to an anti-CD71 mAb-PS ASO conjugate at multiple concentrations, with the relevant vehicle control. Two rounds of PCR amplification (primary and nested PCR) were performed following cDNA synthesis to detect exon-skipping. PCR reactions were analyzed in a 4% TAE agarose gel (FIG. 11). FIG. 11 shows an agarose gel of PMO, ASO, conjugated anti-CD71 mAb-ASO of DAR1 (“ASC-DAR1”), conjugated anti-CD71 mAb-ASO of DAR2 (“ASC-DAR2”), and conjugated anti-CD71 mAb-ASO of DAR3 (“ASC-DAR3”). “PMO” and “ASO” refers to free PMO and ASO, unconjugated to antibody. “Veh” refers to vehicle only. The concentrations tested included 0.2, 1, and 5 micromolar (μM).

Referring to FIG. 11, the anti-CD71 mAb-PS ASO conjugate produced measurable exon 23 skipping in differentiated C2C12 cells and lower concentrations than the “naked” PS ASO control. The wild-type product had an expected size of 788 base pairs and the skipped DMD 423 of 575 base pairs.

Example 6: In Vivo Activity of Anti-CD71 mAb-PMO Conjugate

The anti-CD71 mAb-PMO conjugate was made and characterized as described in Example 3. The conjugate anti-CD71 mAb-PMO DAR1,2 anti-CD71 and mAb-PMO DAR>2 were assessed for its ability to mediate exon skipping in vivo in wild-type CD-1 mice using similar methods as described in Example 2. “DAR” refers to drug-to-antibody ratio.

Mice were dosed via intravenous (iv) injection with the mAb, vehicle control, and antisense conjugates (ASCs) at the doses as provided in Table 12. “DAR” refers to drug-to-antibody ratio. The “naked” PMO was dosed via intramuscular injection into the gastrocnemius muscle at the doses provided in Table 12. After 4, 7, or 14 days, heart and gastrocnemius muscle tissues were harvested and snap-frozen in liquid nitrogen. RNAs were isolated, reversed transcribed and a nested PCR reactions were performed. PCR reactions were analyzed in 4% TAE agarose gels which were then quantitated by densitometry.

TABLE 12 In vivo study design PMO PMO: mAb Dose mAb Harvest dose (mg/ Ratio Time Group Test Article N (mg/kg) kg) (mol/mol) (h)  1 anti-CD71 mAb- 3 50 4.8 1.6 96 PMO, DAR1,2  2 anti-CD71 mAb- 3 50 4.8 1.6 168 PMO, DAR1,2  3 anti-CD71 mAb- 3 50 4.8 1.6 336 PMO, DAR1,2  4 anti-CD71 mAb- 3 50 10.5 3.7 96 PMO, DAR>2  5 anti-CD71 mAb- 3 50 10.5 3.7 168 PMO, DAR>2  6 anti-CD71 mAb- 3 50 10.5 3.7 336 PMO, DAR>2  7 anti-CD71 mAb 3 50 96  8 anti-CD71 mAb 3 50 168  9 anti-CD71 mAb 3 50 336 10 PMO 3 40 ug/inj. 96 11 PMO 3 40 ug/inj. 168 12 PMO 3 40 ug/inj. 336 13 Vehicle 3 96 14 Vehicle 3 168 15 Vehicle 3 336

FIG. 12A shows a gel electrophoresis of gastrocnemius muscle samples from mice administered anti-CD71 mAb-PMO DAR 1, 2, anti-CD71 mAb-PMO DAR>2, anti-CD71 mAb, PMO, and vehicle for 4, 7, or 14 days. The wild-type product had an expected size of 788 base pairs and the skipped DMD 423 of 575 base pairs. Anti-CD71 mAb-PMO DAR 1,2 and anti-CD71 mAb-PMO DAR>2 produced measurable exon 23 skipping in gastrocnemius muscle and lower concentrations than the “naked” PMO control. The intensity of the bands on the gel (FIG. 12A) was quantitated by densitometry as seen in FIG. 12B. FIG. 12C shows the quantification of in vivo exon skipping in wild-type mice gastrocnemius muscle using Taqman qPCR.

FIG. 13A shows a gel electrophoresis of heart samples from mice administered anti-CD71 mAb-PMO DAR 1, 2, anti-CD71 mAb-PMO DAR>2, anti-CD71 mAb, PMO, and vehicle for 4, 7, or 14 days. The wild-type product had an expected size of 788 base pairs and the skipped DMD Δ23 of 575 base pairs. The intensity of the bands on the gel (FIG. 13A) was quantitated by densitometry as seen in FIG. 13B. Similar results as with the gastrocnemius muscle samples were obtained. Anti-CD71 mAb-PMO DAR 1,2 and anti-CD71 mAb-PMO DAR>2 produced measurable exon 23 skipping in gastrocnemius muscle and lower concentrations than the “naked” PMO control.

DNA fragments were then isolated from the 4% agarose gels and sequenced. The sequencing data confirmed the correct sequence in the skipped and wild-type products as seen in FIG. 14.

Example 7. Antisense Oligonucleotide Sequences and Synthesis

The sequences in Table 13 were made targeting different exons in different genes.

TABLE 13 Sequences SEQ ID NO. Target PMO sequence (5′ to 3′) 45 Exon 23 GGCCAAACCTCGGCTTACCTGAAAT in mouse dystrophin 46 Exon 2 AGCCCATCTTCTCCTGGTCCTGGGAAGG in mouse myostatin (MSTN) 47 Exon 11 ATCCTCTTTGGTAACCTCACCTCAC in mouse phenylalanine hydroxylase (PAH) 48 KRAS-011 TCGTCCACAAAATGATTCTGAATTA (human cancer) 49 Scramble CGGTGTGTGTATCATTCTCTAGTGT

Example 8. In Vivo Activity of CD71 mAb-PMO Conjugate in Multiple Tissues

The CD71 mAb-PMO conjugates were made and characterized as described in Example 3. The conjugate (DAR3+) was assessed for its ability to mediate exon skipping in vivo in wild type CD-1 mice, see example 2 for full experimental details. In brief, mice were dosed via intravenous (iv) injection with vehicle control and indicated ASCs at the doses indicated, see FIG. 7A. After 7, 14 or 28 days, diaphragm, heart and gastrocnemius muscle tissues were harvested and snap-frozen in liquid nitrogen. RNAs were isolated, reversed transcribed, real-time qPCR and nested PCR reactions were performed as described in Example 2 using the appropriate primer/probe sets. PCR reactions were analyzed in 1% TAE agarose gels.

In vivo study design to assess the ability of the CD71 mAb-PMO conjugate to mediate exon 23 skipping in wild type mice is seen in Table 14.

TABLE 14 In vivo study design mAb- PMO mAb PMO PMO:mAb Harvest dose Dose Ratio Time Group Test Article N (mg/kg) (mg/kg) (mol/mol) (WEEKS) 1 Vehicle 3 1 2 Vehicle 3 4 3 CD71-scr, DAR3+ 3 50 10 3.0 2 4 CD71-DMD PMO, 3 50 10 3.0 1 DAR3+ 5 CD71-DMD PMO, 3 50 10 3.0 2 DAR3+ 6 CD71-DMD PMO, 3 50 10 3.0 4 DAR3+

Referring to FIG. 15A, FIG. 15C, and FIG. 15E, in vivo exon skipping was measured in wild type mice in the gastrocnemius (FIG. 15A), diaphragm (FIG. 15C) and heart muscle (FIG. 15E) using Taqman qPCR. Referring to FIG. 15B, FIG. 15D, and FIG. 15F, the CD71 mAb-PMO conjugates produced measurable exon23 skipping in gastrocnemius (FIG. 15B), diaphragm (FIG. 15D), and heart muscle (FIG. 15F) using nested PCR. The wild type product had an expected size of 788 bp, and the skipped DMD 423 had a size of 575 bp. The intensity of the bands on the gel was quantitated by densitometry, and the data are presented as the % of skipped product compared to wild-type dystrophin.

Example 9. In Vivo Activity of CD71 mAb-PMO Conjugates Against Mouse MSTN

The CD71 mAb-PMO conjugate targeting exon 2 of mouse myostatin (5′ AGCCCATCTTCTCCTGGTCCTGGGAAGG) (SEQ ID NO: 46) was made and characterized as described in Example 3. The conjugates (DAR1/2 and DAR3+) were assessed for its ability to mediate exon skipping in vivo in wild type CD-1 mice using similar methods as described in Example 2. In brief, mice were dosed via intravenous (iv) injection with the mAb, vehicle control and indicated ASCs at the doses indicated as seen in Table 15.

TABLE 15 In vivo study design mAb- PMO mAb PMO PMO:mAb Harvest dose Dose Ratio Time Group Test Article N (mg/kg) (mg/kg) (mol/mol) (WEEKS)  1 CD71 mAb-PMO. 3 50 5 1.5 1 DAR1/2  2 CD71 mAb-PMO. 3 50 5 1.5 2 DAR1/2  3 CD71 mAb-PMO. 3 50 5 1.5 4 DAR1/2  4 CD71 mAb-PMO. 3 50 10 3.0 1 DAR3+  5 CD71 mAb-PMO. 3 50 10 3.0 2 DAR3+  6 CD71 mAb-PMO. 3 50 10 3.0 4 DAR3+  7 CD71-scr, DAR1/2 3 50 5 1.5 2  8 CD71-scr, DAR3+ 3 50 10 3.0 2  9 Vehicle 3 1 10 Vehicle 3 2 11 Vehicle 3 4

After 7, 14 or 28 days, diaphragm, heart and gastrocnemius muscle tissues were harvested and snap-frozen in liquid nitrogen. RNAs were isolated and reversed transcribed. PCR reactions were performed with forward primer (mMSTN-F1: 5′ CCTGGAAACAGCTCCTAACATC) (SEQ ID NO: 50) and reverse primer (mMSTN-R1: 5′CAGTCAAGCCCAAAGTCTCTC) (SEQ ID NO: 51) (hot start: 95° C. for 2 minutes, Denaturation at 95° C. for 45 seconds, Annealing of primers at 56° C. for 30 seconds, primer extension at 72° C. for 40 seconds for 35 cycles). PCR reactions were analyzed in a 1% TAE agarose gel as seen in FIGS. 16A-16C. The CD71 mAb-PMO conjugates produced measurable exon2 skipping in mouse diaphragm (FIG. 16A), heart (FIG. 16B) and gastrocnemius (FIG. 16C) muscle tissues. The wild type product had an expected size of 622 bp and the skipped MSTN 42 of 248 bp.

Example 10. In Vitro Activity of ASGPR mAb-PMO Conjugates Against the PAH Gene

The ASGPR mAb-PMO (5′ATCCTCTTTGGTAACCTCACCTCAC) (SEQ ID NO: 47) conjugate targeting exon 11 of mouse PAH was made and characterized as described in Example 3. The conjugate was assessed for its ability to mediate exon 11 skipping in the mouse PAH gene in vitro in primary mouse hepatocytes using PCR (forward primer 5′-CTAGTGCCCTTGTTTTCAGA-3′ (SEQ ID NO: 52) and reverse primer 5′-AGGATCTACCACTGATGGGT-3′) (SEQ ID NO: 53). In brief, the potency of ASGPR mAb-PAH PMO conjugate was compared to ASGPR mAb-scramble PMO at multiple concentrations, with the relevant vehicle control. RNAiMAX was also used to transfect the conjugates as positive controls. PCR reactions were analyzed in a 1% TAE agarose gel as seen in FIG. 17. As seen from the gel in FIG. 17, the ASGPR mAb-PMO conjugate produced measurable exon11 skipping comparable to the RNAiMAX transfected controls. The wild type product had an expected size of 703 bp and the skipped PAH All of 569 bp.

Example 11. In Vivo Activity of ASGPR mAb-PMO Conjugates

The ASGPR mAb-PMO (5′ATCCTCTTTGGTAACCTCACCTCAC) (SEQ ID NO: 47) conjugate targeting exon 11 of mouse PAH was made and characterized as described in Example 3. The conjugate (DAR1/2 and DAR3+) was assessed for its ability to mediate exon skipping in vivo in wild type CD-1 mice using methods as described in Example 2. In brief, mice were dosed via intravenous (iv) injection with the mAb, vehicle control and indicated ASCs at the doses indicated as seen in Table 16.

TABLE 16 In vivo study design mAb- ASO PMO Har- mAb Dose PMO:mAb vest dose (mg/ Ratio Time Group Test Article N (mg/kg) kg) (mol/mol) (Weeks)  1 ASGPR mAb-PMO, 3 50 5 1.5 1 DAR1/2  2 ASGPR mAb-PMO, 3 50 5 1.5 2 DAR1/2  3 ASGPR mAb-PMO, 3 50 5 1.5 4 DAR1/2  4 ASGPR mAb-PMO, 2 50 10 3.0 1 DAR3+  5 ASGPR mAb-PMO, 2 50 10 3.0 2 DAR3+  6 ASGPR mAb-PMO, 2 50 10 3.0 4 DAR3+  7 ASGPR-Scr, DAR1/2 3 50 1.5 2  8 ASGPR-Scr, DAR3+ 3 50 3.0 2  9 Vehicle 3 1 10 Vehicle 3 2 11 Vehicle 3 4

RNAs were isolated from harvested liver tissues and reverse transcribed. PCR reactions using forward primer 5′-CTAGTGCCCTTGTTTTCAGA-3′ (SEQ ID NO: 52) and reverse primer 5′-AGGATCTACCACTGATGGGT-3′ (SEQ ID NO: 53) were analyzed in a 1% TAE agarose gel as seen in FIG. 18. As can be seen from the gel in FIG. 18, the ASGPR mAb-PMO conjugates produced measurable exon11 skipping in mouse livers up to two weeks. The wild type product had an expected size of 703 bp and the skipped PAH All of 569 bp.

Example 12. Sequences

Table 17 illustrates exemplary target sequences to induce insertion, deletion, duplications, or alteration in the DMD gene using compositions and methods as described herein. Table 18 illustrates exemplary nucleotide sequences to induce an insertion, deletion, duplication, or alteration in the DMD gene using compositions and methods as described herein. Table 19 and Table 20 illustrate exemplary target sequences in several genes for inducing an insertion, deletion, duplications, or alteration in the gene. Table 21 illustrates exemplary sequences, including sequences in the DMD gene to induce an insertion, deletion, duplication, or alteration in the gene using compositions and methods as described herein.

TABLE 17 SEQ Target ID Exon Antisense Sequence NO. 19 5′ GCCUGAGCUGAUCUGCUGGCAUCUUGCAGUU 3′ 54 19 or 20 5′GCAGAAUUCGAUCCACCGGCUGUUCAAGCCUG 55 AGCUGAUCUGCUCGCAUCUUGCAGU3′ 20 5′ CAGCAGUAGUUGUCAUCUGCUC 3′ 56 21 5′ CACAAAGUCUGCAUCCAGGAACAUGGGUC 3′ 57 22 5′ CUGCAAUUCCCCGAGUCUCUGC 3′ 58 51 5′ CUCAUACCUUCUGCUUGAUGAUC 3′ 59 52 5′ UCCAACUGGGGACGCCUCUGUUCCAAAUCC 3′ 60

TABLE 18 Gene Target Location Nucleotide Sequence (5′-3′) SEQ ID NO. DMD H8A(−06 + 18) GAUAGGUGGUAUCAACAUCUGUAA 61 DMD H8A(−03 + 18) GAUAGGUGGUAUCAACAUCUG 62 DMD H8A(−07 + 18) GAUAGGUGGUAUCAACAUCUGUAAG 63 DMD H8A(−06 + 14) GGUGGUAUCAACAUCUGUAA 64 DMD H8A(−10 + 10) GUAUCAACAUCUGUAAGCAC 65 DMD H7A(+45 + 67) UGCAUGUUCCAGUCGUUGUGUGG 66 DMD H7A(+02 + 26) CACUAUUCCAGUCAAAUAGGUCUGG 67 DMD H7D(+15 − 10) AUUUACCAACCUUCAGGAUCGAGUA 68 DMD H7A(−18 + 03) GGCCUAAAACACAUACACAUA 69 DMD C6A(−10 + 10) CAUUUUUGACCUACAUGUGG 70 DMD C6A(−14 + 06) UUUGACCUACAUGUGGAAAG 71 DMD C6A(−14 + 12) UACAUUUUUGACCUACAUGUGGAAAG 72 DMD C6A(−13 + 09) AUUUUUGACCUACAUGGGAAAG 73 DMD CH6A(+69 + 91) UACGAGUUGAUUGUCGGACCCAG 74 DMD C6D(+12 − 13) GUGGUCUCCUUACCUAUGACUGUGG 75 DMD C6D(+06 − 11) GGUCUCCUUACCUAUGA 76 DMD H6D(+04 − 21) UGUCUCAGUAAUCUUCUUACCUAU 77 DMD H6D(+18 − 04) UCUUACCUAUGACUAUGGAUGAGA 78 DMD H4A(+13 + 32) GCAUGAACUCUUGUGGAUCC 79 DMD H4D(+04 − 16) CCAGGGUACUACUUACAUUA 80 DMD H4D(−24 − 44) AUCGUGUGUCACAGCAUCCAG 81 DMD H4A(+11 + 40) UGUUCAGGGCAUGAACUCUUGUGGAUCC 82 UU DMD H3A(+30 + 60) UAGGAGGCGCCUCCCAUCCUGUAGGUCA 83 CUG DMD H3A(+35 + 65) AGGUCUAGGAGGCGCCUCCCAUCCUGUA 84 GGU DMD H3A(+30 + 54) GCGCCUCCCAUCCUGUAGGUCACUG 85 DMD H3D(+46 − 21) CUUCGAGGAGGUCUAGGAGGCGCCUC 86 DMD H3A(+30 + 50) CUCCCAUCCUGUAGGUCACUG 87 DMD H3D(+19 − 03) UACCAGUUUUUGCCCUGUCAGG 88 DMD H3A(−06 + 20) UCAAUAUGCUGCUUCCCAAACUGAAA 89 DMD H3A(+37 + 61) CUAGGAGGCGCCUCCCAUCCUGUAG 90 DMD H5A(+20 + 50) UUAUGAUUUCCAUCUACGAUGUCAGUAC 91 UUC DMD H5D(+25 − 05) CUUACCUGCCAGUGGAGGAUUAUAUUCC 92 AAA DMD H5D(+10 − 15) CAUCAGGAUUCUUACCUGCCAGUGG 93 DMD H5A(+10 + 34) CGAUGUCAGUACUUCCAAUAUUCAC 94 DMD H5D(−04 − 21) ACCAUUCAUCAGGAUUCU 95 DMD H5D(+16 − 02) ACCUGCCAGUGGAGGAUU 96 DMD H5A(−07 + 20) CCAAUAUUCACUAAAUCAACCUGUUAA 97 DMD H5D(+18 − 12) CAGGAUUGUUACCUGCCAGUGGAGGAUU 98 AU DMD H5A(+05 + 35) ACGAUGUCAGUACUUCCAAUAUUCACUA 99 AAU DMD H5A(+15 + 45) AUUUCCAUCUACGAUGUCAGUACUUCCA 100 AUA DMD H10A(−05 + 16) CAGGAGCUUCCAAAUGCUGCA 101 DMD H10A(−05 + 24) CUUGUCUUCAGGAGCUUCCAAAUGCUGC 102 A DMD H10A(+98 + 119) UCCUCAGCAGAAAGAAGCCACG 103 DMD H10A(+130 + 149) UUAGAAAUCUCUCCUUGUGC 104 DMD H10A(−33 − 14) UAAAUUGGGUGUUACACAAU 105 DMD H11D(+26 + 49) CCCUGAGGCAUUCCCAUCUUGAAU 106 DMD H11D(+11 − 09) AGGACUUACUUGCUUUGUUU 107 DMD H11A(+118 + 140) CUUGAAUUUAGGAGAUUCAUCUG 108 DMD H11A(+75 + 97) CAUCUUCUGAUAAUUUUCCUGUU 109 DMD H12A(+52 + 75) UCUUCUGUUUUUGUUAGCCAGUCA 110 DMD H12A(−10 + 10) UCUAUGUAAACUGAAAAUUU 111 DMD H12A(+11 + 30) UUCUGGAGAUCCAUUAAAAC 112 DMD H13A(+77 + 100) CAGCAGUUGCGUGAUCUCCACUAG 113 DMD H13A(+55 + 75) UUCAUCAACUACCACCACCAU 114 DMD H13D(+06 − 19) CUAAGCAAAAUAAUCUGACCUUAAG 115 DMD H14A(+37 + 64) CUUGUAAAAGAACCCAGCGGUCUUCUGU 116 DMD H14A(+14 + 35) CAUCUACAGAUGUUUGCCCAUC 117 DMD H14A(+51 + 73) GAAGGAUGUCUUGUAAAAGAACC 118 DMD H14D(−02 + 18) ACCUGUUCUUCAGUAAGACG 119 DMD H14D(+14 − 10) CAUGACACACCUGUUCUUCAGUAA 120 DMD H14A(+61 + 80) CAUUUGAGAAGGAUGUCUUG 121 DMD H14A(−12 + 12) AUCUCCCAAUACCUGGAGAAGAGA 122 DMD H15A(−12 + 19) GCCAUGCACUAAAAAGGCACUGCAAGAC 123 AUU DMD H15A(+48 + 71) UCUUUAAAGCCAGUUGUGUGAAUC 124 DMD H15A(+08 + 28) UUUCUGAAAGCCAUGCACUAA 125 DMD H15D(+17 − 08) GUACAUACGGCCAGUUUUUGAAGAC 126 DMD H16A(−12 + 19) CUAGAUCCGCUUUUAAAACCUGUUAAAA 127 CAA DMD H16A(−06 + 25) UCUUUUCUAGAUCCGCUUUUAAAACCUG 128 UUA DMD H16A(−06 + 19) CUAGAUCCGCUUUUAAAACCUGUUA 129 DMD H16A(+87 + 109) CCGUCUUCUGGGUCACUGACUUA 130 DMD H16A(−07 + 19) CUAGAUCCGCUUUUAAAACCUGUUAA 131 DMD H16A(−07 + 13) CCGCUUUUAAAACCUGUUAA 132 DMD H16A(+12 + 37) UGGAUUGCUUUUUCUUUUCUAGAUCC 133 DMD H16A(+92 + 116) CAUGCUUCCGUCUUCUGGGUCACUG 134 DMD H16A(+45 + 67) GAUCUUGUUUGAGUGAAUACAGU 135 DMD H16A(+105 + 126) GUUAUCCAGCCAUGCUUCCGUC 136 DMD H16D(+05 − 20) UGAUAAUUGGUAUCACUAACCUGUG 137 DMD H16D(+12 − 11) GUAUCACUAACCUGUGCUGUAC 138 DMD H19A(+35 + 53) CUGCUGGCAUCUUGCAGUU 139 DMD H19A(+35 + 65) GCCUGAGCUGAUCUGCUGGCAUCUUGCA 140 GUU DMD H20A(+44 + 71) CUGGCAGAAUUCGAUCCACCGGCUGUUC 141 DMD H20A(+147 + 168) CAGCAGUAGUUGUCAUCUGCUC 142 DMD H20A(+185 + 203) UGAUGGGGUGGUGGGUUGG 143 DMD H20A(−08 + 17) AUCUGCAUUAACACCCUCUAGAAAG 144 DMD H20A(+30 + 53) CCGGCUGUUCAGUUGUUCUGAGGC 145 DMD H20A(−11 + 17) AUCUGCAUUAACACCCUCUAGAAAGAAA 146 DMD H20D(+08 − 20) GAAGGAGAAGAGAUUCUUACCUUACAAA 147 DMD H20A(+44 + 63) AUUCGAUCCACCGGCUGUUC 148 DMD H20A(+149 + 168 CAGCAGUAGUUGUCAUCUGC 149 DMD H21A(−06 + 16) GCCGGUUGACUUCAUCCUGUGC 150 DMD H21A(+85 + 106) CUGCAUCCAGGAACAUGGGUCC 151 DMD H21A(+85 + 108) GUCUGCAUCCAGGAACAUGGGUC 152 DMD H21A(+08 + 31) GUUGAAGAUCUGAUAGCCGGUUGA 153 DMD H21D(+18 − 07) UACUUACUGUCUGUAGCUCUUUCU 154 DMD H22A(+22 + 45) CACUCAUGGUCUCCUGAUAGCGCA 155 DMD H22A(+125 + 106) CUGCAAUUCCCCGAGUCUCUGC 156 DMD H22A(+47 + 69) ACUGCUGGACCCAUGUCCUGAUG 157 DMD H22A(+80 + 101) CUAAGUUGAGGUAUGGAGAGU 158 DMD H22D(+13 − 11) UAUUCACAGACCUGCAAUUCCCC 159 DMD H23A(+34 + 59) ACAGUGGUGCUGAGAUAGUAUAGGCC 160 DMD H23A(+18 + 39) UAGGCCACUUUGUUGCUCUUGC 161 DMD H23A(+72 + 90) UUCAGAGGGCGCUUUCUUC 162 DMD H24A(+48 + 70) GGGCAGGCCAUUCCUCCUUCAGA 163 DMD H24A(−02 + 22) UCUUCAGGGUUUGUAUGUGAUUCU 164 DMD H25A(+9 + 36) CUGGGCUGAAUUGUCUGAAUAUCACUG 165 DMD H25A(+131 + 156) CUGUUGGCACAUGUGAUCCCACUGAG 166 DMD H25D(+16 − 08) GUCUAUACCUGUUGGCACAUGUGA 167 DMD H26A(+132 + 156) UGCUUUCUGUAAUUCAUCUGGAGUU 168 DMD H26A(−07 + 19) CCUCCUUUCUGGCAUAGACCUUCCAC 169 DMD H26A(+68 + 92) UGUGUCAUCCAUUCGUGCAUCUCUG 170 DMD H27A(+82 + 106) UUAAGGCCUCUUGUGCUACAGGUGG 171 DMD H27A(−4 + 19) GGGGCUCUUCUUUAGCUCUCUGA 172 DMD H27D(+19 − 03) GACUUCCAAAGUCUUGCAUUUC 173 DMD H28A(−05 + 19) GCCAACAUGCCCAAACUUCCUAAG 174 DMD H28A(+99 + 124) CAGAGAUUUCCUCAGCUCCGCCAGGA 175 DMD H28D(+16 − 05) CUUACAUCUAGCACCUCAGAG 176 DMD H29A(+57 + 81) UCCGCCAUCUGUUAGGGUCUGUGCC 177 DMD H29A(+18 + 42) AUUUGGGUUAUCCUCUGAAUGUCGC 178 DMD H29D(+17 − 05) CAUACCUCUUCAUGUAGUUCCC 179 DMD H30A(+122 + 147) CAUUUGAGCUGCGUCCACCUUGUCUG 180 DMD H30A(+25 + 50) UCCUGGGCAGACUGGAUGCUCUGUUC 181 DMD H30D(+19 − 04) UUGCCUGGGCUUCCUGAGGCAUU 182 DMD H31D(+06 −18) UUCUGAAAUAACAUAUACCUGUGC 183 DMD H31D(+03 −22) UAGUUUCUGAAAUAACAUAUACCUG 184 DMD H31A(+05 + 25) GACUUGUCAAAUCAGAUUGGA 185 DMD H31D(+04 − 20) GUUUCUGAAAUAACAUAUACCUGU 186 DMD H32D(+04 − 16) CACCAGAAAUACAUACCACA 187 DMD H32A(+151 + 170) CAAUGAUUUAGCUGUGACUG 188 DMD H32A(+10 + 32) CGAAACUUCAUGGAGACAUCUUG 189 DMD H32A(+49 + 73) CUUGUAGACGCUGCUCAAAAUUGGC 190 DMD H33D(+09 − 11) CAUGCACACACCUUUGCUCC 191 DMD H33A(+53 + 76) UCUGUACAAUCUGACGUCCAGUCU 192 DMD H33A(+30 + 56) GUCUUUAUCACCAUUUCCACUUCAGAC 193 DMD H33A(+64 + 88) CCGUCUGCUUUUUCUGUACAAUCUG 194 DMD H34A(+83 + 104) UCCAUAUCUGUAGCUGCCAGCC 195 DMD H34A(+143 + 165) CCAGGCAACUUCAGAAUCCAAAU 196 DMD H34A(−20 + 10) UUUCUGUUACCUGAAAAGAAUUAUAAU 197 GAA DMD H34A(+46 + 70) CAUUCAUUUCCUUUCGCAUCUUACG 198 DMD H34A(+95 + 120) UGAUCUCUUUGUCAAUUCCAUAUCUG 199 DMD H34D(+10 − 20) UUCAGUGAUAUAGGUUUUACCUUUCCCC 200 AG DMD H34A(+72 + 96) CUG UAG CUG CCA GCC AUU CUG UCA 201 AG DMD H35A(+141 + 161) UCU UCU GCU CGG GAG GUG ACA 202 DMD H35A(+116 + 135) CCA GUU ACU AUU CAG AAG AC 203 DMD H35A(+24 + 43) UCU UCA GGU GCA CCU UCU GU 204 DMD H36A(+26 + 50) UGUGAUGUGGUCCACAUUCUGGUCA 205 DMD H36A(−02 + 18) CCAUGUGUUUCUGGUAUUCC 206 DMD H37A(+26 + 50) CGUGUAGAGUCCACCUUUGGGCGUA 207 DMD H37A(+82 + 105) UACUAAUUUCCUGCAGUGGUCACC 208 DMD H37A(+134 + 157) UUCUGUGUGAAAUGGCUGCAAAUC 209 DMD H38A(−01 + 19) CCUUCAAAGGAAUGGAGGCC 210 DMD H38A(+59 + 83) UGCUGAAUUUCAGCCUCCAGUGGUU 211 DMD H38A(+88 + 112) UGAAGUCUUCCUCUUUCAGAUUCAC 212 DMD H39A(+62 + 85) CUGGCUUUCUCUCAUCUGUGAUUC 213 DMD H39A(+39 + 58) GUUGUAAGUUGUCUCCUCUU 214 DMD H39A(+102 + 121) UUGUCUGUAACAGCUGCUGU 215 DMD H39D(+10 − 10) GCUCUAAUACCUUGAGAGCA 216 DMD H40A(−05 + 17) CUUUGAGACCUCAAAUCCUGUU 217 DMD H40A(+129 + 153) CUUUAUUUUCCUUUCAUCUCUGGGC 218 DMD H42A(−04 + 23) AUCGUUUCUUCACGGACAGUGUGCUGG 219 DMD H42A(+86 + 109) GGGCUUGUGAGACAUGAGUGAUUU 220 DMD H42D(+19 − 02) ACCUUCAGAGGACUCCUCUUGC 221 DMD H43D(+10 − 15) UAUGUGUUACCUACCCUUGUCGGUC 222 DMD H43A(+101 + 120) GGAGAGAGCUUCCUGUAGCU 223 DMD H43A(+78 + 100) UCACCCUUUCCACAGGCGUUGCA 224 DMD H44A(+85 + 104) UUUGUGUCUUUCUGAGAAAC 225 DMD H44D(+10 − 10) AAAGACUUACCUUAAGAUAC 226 DMD H44A(+06 + 14) AUCUGUCAAAUCGCCUGCAG 227 DMD H46D(+16 − 04) UUACCUUGACUUGCUCAAGC 228 DMD H46A(+90 + 109) UCCAGGUUCAAGUGGGAUAC 229 DMD H47A(+76 + 100) GCUCUUCUGGGCUUAUGGGAGCACU 230 DMD H47D(+25 − 02) ACCUUUAUCCACUGGAGAUUUGUCUGC 231 DMD H47A(−9 + 12) UUCCACCAGUAACUGAAACAG 232 DMD H50A(+02 + 30) CCACUCAGAGCUCAGAUCUUCUAACUUC 233 C DMD H50A(+07 + 33) CUUCCACUCAGAGCUCAGAUCUUCUAA 234 DMD H50D(+07 − 18) GGGAUCCAGUAUACUUACAGGCUCC 235 DMD H51A(−01 + 25) ACCAGAGUAACAGUCUGAGUAGGAGC 236 DMD H51D(+16 − 07) CUCAUACCUUCUGCUUGAUGAUC 237 DMD H51A(+111 + 134) UUCUGUCCAAGCCCGGUUGAAAUC 238 DMD H51A(+61 + 90) ACAUCAAGGAAGAUGGCAUUUCUAGUUU 239 GG DMD H51A(+66 + 90) ACAUCAAGGAAGAUGGCAUUUCUAG 240 DMD H51A(+66 + 95) CUCCAACAUCAAGGAAGAUGGCAUUUCU 241 AG DMD H51D(+08 − 17) AUCAUUUUUUCUCAUACCUUCUGCU 242 DMD H51A/D(+08 − 17) & AUCAUUUUUUCUCAUACCUUCUGCUAG 243 (−15+) GAGCUAAAA DMD H51A(+175 + 195) CACCCACCAUCACCCUCUGUG 245 DMD H51A(+199 + 220) AUCAUCUCGUUGAUAUCCUCAA 246 DMD H52A(+07 + 14) UCCUGCAUUGUUGCCUGUAAG 247 DMD H52A(+12 + 41) UCCAACUGGGGACGCCUCUGUUCCAAAU 248 CC DMD H52A(+17 + 37) ACUGGGGACGCCUCUGUUCCA 249 DMD H52A(+93 + 112) CCGUAAUGAUUGUUCUAGCC 250 DMD H52D(+05 − 15) UGUUAAAAAACUUACUUCGA 251 DMD H53A(+45 + 69) CAUUCAACUGUUGCCUCCGGUUCUG 252 DMD H53A(+39 + 62) CUGUUGCCUCCGGUUCUGAAGGUG 253 DMD H53A(+39 + 69) CAUUCAACUGUUGCCUCCGGUUCUGAAG 254 GUG DMD H53D(+14 − 07) UACUAACCUUGGUUUCUGUGA 255 DMD H53A(+23 + 47) CUGAAGGUGUUCUUGUACUUCAUCC 256 DMD H53A(+150 + 176) UGUAUAGGGACCCUCCUUCCAUGACUC 257 DMD H53D(+20 − 05) CUAACCUUGGUUUCUGUGAUUUUCU 258 DMD H53D(+09 − 18) GGUAUCUUUGAUACUAACCUUGGUUUC 259 DMD H53A(−12 + 10) AUUCUUUCAACUAGAAUAAAAG 260 DMD H53A(−07 + 18) GAUUCUGAAUUCUUUCAACUAGAAU 261 DMD H53A(+07 + 26) AUCCCACUGAUUCUGAAUUC 262 DMD H53A(+124 + 145) UUGGCUCUGGCCUGUCCUAAGA 263 DMD H46A(+86 + 115) CUCUUUUCCAGGUUCAAGUGGGAUACUA 264 GC DMD H46A(+107 + 137) CAAGCUUUUCUUUUAGUUGCUGCUCUUU 265 UCC DMD H46A(−10 + 20) UAUUCUUUUGUUCUUCUAGCCUGGAGAA 266 AG DMD H46A(+50 + 77) CUGCUUCCUCCAACCAUAAAACAAAUUC 267 DMD H45A(−06 + 20) CCAAUGCCAUCCUGGAGUUCCUGUAA 268 DMD H45A(+91 + 110) UCCUGUAGAAUACUGGCAUC 269 DMD H45A(+125 + 151) UGCAGACCUCCUGCCACCGCAGAUUCA 270 DMD H45D(+16 − 04) CUACCUCUUUUUUCUGUCUG 271 DMD H45A(+71 + 90) UGUUUUUGAGGAUUGCUGAA 272 * The first letter designates the species (e.g. H: human, M: murine, C: canine). “#” designates target DMD exon number. “A/D” indicates acceptor or donor splice site at the beginning and end of the exon, respectively. (x y) represents the annealing coordinates where “−” or “+” indicate intronic or exonic sequences respectively.

TABLE 19 SEQ ID Gene Nucleotide Sequence (5′ - 3′) NO. Bcl-x TGGTTCTTACCCAGCCGCCG 273 β-g1obin GTTATTCTTTAGAATGGTGC 274 623 β-g1obin TGCTATTACCTTAACCCAGA 275 654 c-myc CTGTGCTTACCGGGTTTTCCACCTCCC 276 c-myc ATCGTCGTGACTGTCTGTTGGAGGG 277 c-myc GCTCACGTTGAGGGGCATCG 278 c-myc ACGTTGAGGGGCATCGTCGC 279 c-myc GGGGCAUCGUCGUGACUGU/CUGUUGGAGGG 280 c-myc CGUCGUGACUGUCUGUUGGAGG 281 c-myc CGTCGTGACTGTCTGTTGGAGG 282 c-myc GGCAUCGUCGCGGGAGGCUGCUGGAGCG 283 c-myc CCGCGACAUAGGACGGAGAGCAGAGCCC 284 c-myc ACTGTGAGGGCGATCGCTGC 285 c-myc ACGATGAGTGGCATAGTCGC 286 c-myc GGCATCGTCGCGGGAGGCTG 287 c-myc GGGCATCGTCGCGGGAGGCT 288 c-myc GGGGCATCGTCGCGGGAGGC 289 c-myc AGGGGCATCGTCGCGGGAGG 290 c-myc GAGGGGCATCGTCGCGGGAG 291 c-myc TGAGGGGCATCGTCGCGGGA 292 c-myc TTGAGGGGCATCGTCGCGGG 293 c-myc GTTGAGGGGCATCGTCGCGG 294 c-myc CGTTGAGGGGCATCGTCGCG 295 c-myc ACGTTGAGGGGCATCGTCGC 296 c-myc AACGTTGAGGGGCATCGTCG 297 c-myc TAACGTTGAGGGGCATCGTC 298 c-myc CTAACGTTGAGGGGCATCGT 299 c-myc GCTAACGTTGAGGGGCATCG 300 c-myc AGCTAACGTTGAGGGGCATC 301 c-myc AAGCTAACGTTGAGGGGCAT 302 c-myc GAAGCTAACGTTGAGGGGCA 303 BCL-2 CTCCGCAATGCTGAAAGGTG 304 (rat) PCNA-1 GGCGUGCCUCAAACAUGGUGGCGG 305 (rat)

TABLE 20 Target Gene Location Nucleotide Sequence (5′-3′) SEQ ID NO. Rat c-myc 2553-79 CTGTGCTTACCGGGTTTTCCACCTCCC 306 Rat c-myc 4140-64 ATCGTCGTGACTGTCTGTTGGAGGG 307 Rat c-myc 4161-80 GCTCACGTTGAGGGGCATCG 308 Rat 1155-74 GGTCACTCACCGGTAGAGAA 309 CYP3A2 Rat 1526-45 GGGTTCCAAGTCTATAAAGG 310 CYP3A2 Human   31-44 TGTGTCTTTTCCAG 311 androgen receptor exon 2 Human   45-67 TTTGGAGACTGCCAGGGACCATG 312 androgen receptor exon 2 Human   48-67 CATGGTCCCTGGCAGTCTCC 313 androgen receptor exon 2 Human   45-80 TCAATGGGCAAAACATGGTCCCTGGCAGTCTC 314 androgen CAAA receptor exon 2 Human   28-43 TTTGTGTTCTCCCAG 315 androgen receptor exon 3 Human   44-66 GGAAACAGAAGTACCTGTGCGCC 316 androgen receptor exon 3 Human   49-66 GGCGCACAGGTACTTCTG 317 androgen receptor exon 3 Human   44-79 AATCATTTCTGCTGGCGCACAGGTACTTCTGTT 318 androgen TCC receptor exon 3 Human 1321-38 CCCCTGCAGCACGCGGGT 319 HCG-β subunit Human 1321-57 GAGGCAGGGCCGGCAGGACCCCCTGCAGCACG 320 HCG-β CGGGT subunit Human c- 4506-25 GGCATCGTCGCGGGAGGCTG 321 myc Human c- 4507-26 GGGCATCGTCGCGGGAGGCT 322 myc Human c- 4508-27 GGGGCATCGTCGCGGGAGGC 323 myc Human c- 4509-28 AGGGGCATCGTCGCGGGAGG 324 myc Human c- 4510-29 GAGGGGCATCGTCGCGGGAG 325 myc Human c- 4511-30 TGAGGGGCATCGTCGCGGGA 326 myc Human c- 4512-31 TTGAGGGGCATCGTCGCGGG 327 myc Human c- 4513-32 GTTGAGGGGCATCGTCGCGG 328 myc Human c- 4514-33 CGTTGAGGGGCATCGTCGCG 329 myc Human c- 4515-34 ACGTTGAGGGGCATCGTCGC 330 myc Human c- 4516-35 AACGTTGAGGGGCATCGTCG 331 myc Human c- 4517-36 TAACGTTGAGGGGCATCGTC 332 myc Human c- 4518-37 CTAACGTTGAGGGGCATCGT 333 myc Human c- 4519-38 GCTAACGTTGAGGGGCATCG 334 myc Human c- 4520-39 AGCTAACGTTGAGGGGCATC 335 myc Human c- 4521-40 AAGCTAACGTTGAGGGGCAT 336 myc Human c- 4522-41 GAAGCTAACGTTGAGGGGCA 337 myc Human c- 6656-75 TCCTCATCTTCTTGTTCCTC 338 myc Human c- 6656-91 AACAACATCGATTTCTTCCTCATCTTCTTGTTC 339 myc CTC Human 11691-708 CCCGGAAGGCAGTCTGGC 340 p53 Human 11689-724 TCCTCCATGGCAGTGACCCGGAAGGCAGTCTG 341 p53 GCTG Human  376-94 CTACTGGCCGCTGAAGGGC 342 abl (ds of bcr-abl fusion point) Human   374-409 GCTCAAAGTCAGATGCTACTGGCCGCTGAAGG 343 abl (ds of GCTT bcr-abl fusion point) HW-1 rev 5517-43 TCGTCGGTCTCTCCGCTTCTTCTTGCC 344 HW-1 rev   7885-7904 CTCTGGTGGTGGGTAAGGGT 345 HW-1 rev   7885-7921 CGGGTCTGTCGGGTTCCCTCTGGTGGTGGGTAA 346 GGGT Rat c-myc 4140-69 GGGGCAUCGUCGUGACUGUCUGUUGGAGGG 347 Rat c-myc 4141-62 CGUCGUGACUGUCUGUUGGAGG 348 Rat c-myc 4141-62 CGTCGTGACTGTCTGTTGGAGG 349 Human c-   4498-4505 GGCAUCGUCGCGGGAGGCUG/CUGGAGCG 350 myc Rat c-myc 4364-91 CCGCGACAUAGGACGGAGAGCAGAGCCC 351

TABLE 21 Target Nucleotide Sequence (5′ - 3′) SEQ ID NO. Hu.DMD.Exon44.25.001 CTGCAGGTAAAAGCATATGGATCAA 352 Hu.DMD.Exon44.25.002 ATCGCCTGCAGGTAAAAGCATATGG 353 Hu.DMD.Exon44.25.003 GTCAAATCGCCTGCAGGTAAAAGCA 354 Hu.DMD.Exon44.25.004 GATCTGTCAAATCGCCTGCAGGTAA 355 Hu.DMD.Exon44.25.005 CAACAGATCTGTCAAATCGCCTGCA 356 Hu.DMD.Exon44.25.006 TTTCTCAACAGATCTGTCAAATCGC 357 Hu.DMD.Exon44.25.007 CCATTTCTCAACAGATCTGTCAAAT 358 Hu.DMD.Exon44.25.008 ATAATGAAAACGCCGCCATTTCTCA 359 Hu.DMD.Exon44.25.009 AAATATCTTTATATCATAATGAAAA 360 Hu.DMD.Exon44.25.010 TGTTAGCCACTGATTAAATATCTTT 361 Hu.DMD.Exon44.25.01 1AAACTGTTCAGCTTCTGTTAGCCAC 362 Hu.DMD.Exon44.25.012 TTGTGTCTTTCTGAGAAACTGTTCA 363 Hu.DMD.Exon44.25.013 CCAATTCTCAGGAATTTGTGTCTTT 364 Hu.DMD.Exon44.25.014 GTATTTAGCATGTTCCCAATTCTCA 365 Hu.DMD.Exon44.25.015 CTTAAGATACCATTTGTATTTAGCA 366 Hu.DMD.Exon44.25.016 CTTACCTTAAGATACCATTTGTATT 367 Hu.DMD.Exon44.25.017 AAAGACTTACCTTAAGATACCATTT 368 Hu.DMD.Exon44.25.018 AAATCAAAGACTTACCTTAAGATAC 369 Hu.DMD.Exon44.25.019 AAAACAAATCAAAGACTTACCTTAA 370 Hu.DMD.Exon44.25.020 TCGAAAAAACAAATCAAAGACTTAC 371 Hu.DMD.Exon45.25.001 CTGTAAGATACCAAAAAGGCAAAAC 372 Hu.DMD.Exon45.25.002 CCTGTAAGATACCAAAAAGGCAAAA 373 Hu.DMD.Exon45.25.002.2 AGTTCCTGTAAGATACCAAAAAGGC 374 Hu.DMD.Exon45.25.003 GAGTTCCTGTAAGATACCAAAAAGG 375 Hu.DMD.Exon45.25.003.2 CCTGGAGTTCCTGTAAGATACCAAA 376 Hu.DMD.Exon45.25.004 TCCTGGAGTTCCTGTAAGATACCAA 377 Hu.DMD.Exon45.25.004.2 GCCATCCTGGAGTTCCTGTAAGATA 378 Hu.DMD.Exon45.25.005 TGCCATCCTGGAGTTCCTGTAAGAT 379 Hu.DMD.Exon45.25.005.2 CCAATGCCATCCTGGAGTTCCTGTA 380 Hu.DMD.Exon45.25.006 CCCAATGCCATCCTGGAGTTCCTGT 381 Hu.DMD.Exon45.25.006.2 GCTGCCCAATGCCATCCTGGAGTTC 382 Hu.DMD.Exon45.25.007 CGCTGCCCAATGCCATCCTGGAGTT 383 Hu.DMD.Exon45.25.008 AACAGTTTGCCGCTGCCCAATGCCA 384 Hu.DMD.Exon45.25.008.2 CTGACAACAGTTTGCCGCTGCCCAA 385 Hu.DMD.Exon45.25.009 GTTGCATTCAATGTTCTGACAACAG 386 Hu.DMD.Exon45.25.010 GCTGAATTATTTCTTCCCCAGTTGC 387 Hu.DMD.Exon45.25.010.2 ATTATTTCTTCCCCAGTTGCATTCA 388 Hu.DMD.Exon45.25.011 GGCATCTGTTTTTGAGGATTGCTGA 389 Hu.DMD.Exon45.25.011.2 TTTGAGGATTGCTGAATTATTTCTT 390 Hu.DMD.Exon45.25.012 AATTTTTCCTGTAGAATACTGGCAT 391 Hu.DMD.Exon45.25.012.2 ATACTGGCATCTGTTTTTGAGGATT 392 Hu.DMD.Exon45.25.013 ACCGCAGATTCAGGCTTCCCAATTT 393 Hu.DMD.Exon45.25.013.2 AATTTTTCCTGTAGAATACTGGCAT 394 Hu.DMD.Exon45.25.014 CTGTTTGCAGACCTCCTGCCACCGC 395 Hu.DMD.Exon45.25.014.2 AGATTCAGGCTTCCCAATTTTTCCT 396 Hu.DMD.Exon45.25.015 CTCTTTTTTCTGTCTGACAGCTGTT 397 Hu.DMD.Exon45.25.015.2 ACCTCCTGCCACCGCAGATTCAGGC 398 Hu.DMD.Exon45.25.016 CCTACCTCTTTTTTCTGTCTGACAG 399 Hu.DMD.Exon45.25.016.2 GACAGCTGTTTGCAGACCTCCTGCC 400 Hu.DMD.Exon45.25.017 GTCGCCCTACCTCTTTTTTCTGTCT 401 Hu.DMD.Exon45.25.018 GATCTGTCGCCCTACCTCTTTTTTC 402 Hu.DMD.Exon45.25.019 TATTAGATCTGTCGCCCTACCTCTT 403 Hu.DMD.Exon45.25.020 ATTCCTATTAGATCTGTCGCCCTAC 404 Hu.DMD.Exon45.20.001 AGATACCAAAAAGGCAAAAC 405 Hu.DMD.Exon45.20.002 AAGATACCAAAAAGGCAAAA 406 Hu.DMD.Exon45.20.003 CCTGTAAGATACCAAAAAGG 407 Hu.DMD.Exon45.20.004 GAGTTCCTGTAAGATACCAA 408 Hu.DMD.Exon45.20.005 TCCTGGAGTTCCTGTAAGAT 409 Hu.DMD.Exon45.20.006 TGCCATCCTGGAGTTCCTGT 410 Hu.DMD.Exon45.20.007 CCCAATGCCATCCTGGAGTT 411 Hu.DMD.Exon45.20.008 CGCTGCCCAATGCCATCCTG 412 Hu.DMD.Exon45.20.009 CTGACAACAGTTTGCCGCTG 413 Hu.DMD.Exon45.20.010 GTTGCATTCAATGTTCTGAC 414 Hu.DMD.Exon45.20.011 ATTATTTCTTCCCCAGTTGC 415 Hu.DMD.Exon45.20.012 TTTGAGGATTGCTGAATTAT 416 Hu.DMD.Exon45.20.013 ATACTGGCATCTGTTTTTGA 417 Hu.DMD.Exon45.20.014 AATTTTTCCTGTAGAATACT 418 Hu.DMD.Exon45.20.015 AGATTCAGGCTTCCCAATTT 419 Hu.DMD.Exon45.20.016 ACCTCCTGCCACCGCAGATT 420 Hu.DMD.Exon45.20.017 GACAGCTGTTTGCAGACCTC 421 Hu.DMD.Exon45.20.018 CTCTTTTTTCTGTCTGACAG 422 Hu.DMD.Exon45.20.019 CCTACCTCTTTTTTCTGTCT 423 Hu.DMD.Exon45.20.020 GTCGCCCTACCTCTTTTTTC 424 Hu.DMD.Exon45.20.021 GATCTGTCGCCCTACCTCTT 425 Hu.DMD.Exon45.20.022 TATTAGATCTGTCGCCCTAC 426 Hu.DMD.Exon45.20.023 ATTCCTATTAGATCTGTCGC 427 Hu.DMD.Exon46.25.001 GGGGGATTTGAGAAAATAAAATTAC 428 Hu.DMD.Exon46.25.002 ATTTGAGAAAATAAAATTACCTTGA 429 Hu.DMD.Exon46.25.002.2 CTAGCCTGGAGAAAGAAGAATAAAA 430 Hu.DMD.Exon46.25.003 AGAAAATAAAATTACCTTGACTTGC 431 Hu.DMD.Exon46.25.003.2 TTCTTCTAGCCTGGAGAAAGAAGAA 432 Hu.DMD.Exon46.25.004 ATAAAATTACCTTGACTTGCTCAAG 433 Hu.DMD.Exon46.25.004.2 TTTTGTTCTTCTAGCCTGGAGAAAG 434 Hu.DMD.Exon46.25.005 ATTACCTTGACTTGCTCAAGCTTTT 435 Hu.DMD.Exon46.25.005.2 TATTCTTTTGTTCTTCTAGCCTGGA 436 Hu.DMD.Exon46.25.006 CTTGACTTGCTCAAGCTTTTCTTTT 437 Hu.DMD.Exon46.25.006.2 CAAGATATTCTTTTGTTCTTCTAGC 438 Hu.DMD.Exon46.25.007 CTTTTAGTTGCTGCTCTTTTCCAGG 439 Hu.DMD.Exon46.25.008 CCAGGTTCAAGTGGGATACTAGCAA 440 Hu.DMD.Exon46.25.008.2 ATCTCTTTGAAATTCTGACAAGATA 441 Hu.DMD.Exon46.25.009 AGCAATGTTATCTGCTTCCTCCAAC 442 Hu.DMD.Exon46.25.009.2 AACAAATTCATTTAAATCTCTTTGA 443 Hu.DMD.Exon46.25.010 CCAACCATAAAACAAATTCATTTAA 444 Hu.DMD.Exon46.25.010.2 TTCCTCCAACCATAAAACAAATTCA 445 Hu.DMD.Exon46.25.011 TTTAAATCTCTTTGAAATTCTGACA 446 Hu.DMD.Exon46.25.012 TGACAAGATATTCTTTTGTTCTTCT 447 Hu.DMD.Exon46.25.012.2 TTCAAGTGGGATACTAGCAATGTTA 448 Hu.DMD.Exon46.25.013 AGATATTCTTTTGTTCTTCTAGCCT 449 Hu.DMD.Exon46.25.013.2 CTGCTCTTTTCCAGGTTCAAGTGGG 450 Hu.DMD.Exon46.25.014 TTCTTTTGTTCTTCTAGCCTGGAGA 451 Hu.DMD.Exon46.25.014.2 CTTTTCTTTTAGTTGCTGCTCTTTT 452 Hu.DMD.Exon46.25.015 TTGTTCTTCTAGCCTGGAGAAAGAA 453 Hu.DMD.Exon46.25.016 CTTCTAGCCTGGAGAAAGAAGAATA 454 Hu.DMD.Exon46.25.017 AGCCTGGAGAAAGAAGAATAAAATT 455 Hu.DMD.Exon46.25.018 CTGGAGAAAGAAGAATAAAATTGTT 456 Hu.DMD.Exon46.20.001 GAAAGAAGAATAAAATTGTT 457 Hu.DMD.Exon46.20.002 GGAGAAAGAAGAATAAAATT 458 Hu.DMD.Exon46.20.003 AGCCTGGAGAAAGAAGAATA 459 Hu.DMD.Exon46.20.004 CTTCTAGCCTGGAGAAAGAA 460 Hu.DMD.Exon46.20.005 TTGTTCTTCTAGCCTGGAGA 461 Hu.DMD.Exon46.20.006 TTCTTTTGTTCTTCTAGCCT 462 Hu.DMD.Exon46.20.007 TGACAAGATATTCTTTTGTT 463 Hu.DMD.Exon46.20.008 ATCTCTTTGAAATTCTGACA 464 Hu.DMD.Exon46.20.009 AACAAATTCATTTAAATCTC 465 Hu.DMD.Exon46.20.010 TTCCTCCAACCATAAAACAA 466 Hu.DMD.Exon46.20.011 AGCAATGTTATCTGCTTCCT 467 Hu.DMD.Exon46.20.012 TTCAAGTGGGATACTAGCAA 468 Hu.DMD.Exon46.20.013 CTGCTCTTTTCCAGGTTCAA 469 Hu.DMD.Exon46.20.014 CTTTTCTTTTAGTTGCTGCT 470 Hu.DMD.Exon46.20.015 CTTGACTTGCTCAAGCTTTT 471 Hu.DMD.Exon46.20.016 ATTACCTTGACTTGCTCAAG 472 Hu.DMD.Exon46.20.017 ATAAAATTACCTTGACTTGC 473 Hu.DMD.Exon46.20.018 AGAAAATAAAATTACCTTGA 474 Hu.DMD.Exon46.20.019 ATTTGAGAAAATAAAATTAC 475 Hu.DMD.Exon46.20.020 GGGGGATTTGAGAAAATAAA 476 Hu.DMD.Exon47.25.001 CTGAAACAGACAAATGCAACAACGT 477 Hu.DMD.Exon47.25.002 AGTAACTGAAACAGACAAATGCAAC 478 Hu.DMD.Exon47.25.003 CCACCAGTAACTGAAACAGACAAAT 479 Hu.DMD.Exon47.25.004 CTCTTCCACCAGTAACTGAAACAGA 480 Hu.DMD.Exon47.25.005 GGCAACTCTTCCACCAGTAACTGAA 481 Hu.DMD.Exon47.25.006 GCAGGGGCAACTCTTCCACCAGTAA 482 Hu.DMD.Exon47.25.007 CTGGCGCAGGGGCAACTCTTCCACC 483 Hu.DMD.Exon47.25.008 TTTAATTGTTTGAGAATTCCCTGGC 484 Hu.DMD.Exon47.25.008.2 TTGTTTGAGAATTCCCTGGCGCAGG 485 Hu.DMD.Exon47.25.009 GCACGGGTCCTCCAGTTTCATTTAA 486 Hu.DMD.Exon47.25.009.2 TCCAGTTTCATTTAATTGTTTGAGA 487 Hu.DMD.Exon47.25.010 GCTTATGGGAGCACTTACAAGCACG 488 Hu.DMD.Exon47.25.010.2 TACAAGCACGGGTCCTCCAGTTTCA 489 Hu.DMD.Exon47.25.011 AGTTTATCTTGCTCTTCTGGGCTTA 490 Hu.DMD.Exon47.25.012 TCTGCTTGAGCTTATTTTCAAGTTT 491 Hu.DMD.Exon47.25.012.2 ATCTTGCTCTTCTGGGCTTATGGGA 492 Hu.DMD.Exon47.25.013 CTTTATCCACTGGAGATTTGTCTGC 493 Hu.DMD.Exon47.25.013.2 CTTATTTTCAAGTTTATCTTGCTCT 494 Hu.DMD.Exon47.25.014 CTAACCTTTATCCACTGGAGATTTG 495 Hu.DMD.Exon47.25.014.2 ATTTGTCTGCTTGAGCTTATTTTCA 496 Hu.DMD.Exon47.25.015 AATGTCTAACCTTTATCCACTGGAG 497 Hu.DMD.Exon47.25.016 TGGTTAATGTCTAACCTTTATCCAC 498 Hu.DMD.Exon47.25.017 AGAGATGGTTAATGTCTAACCTTTA 499 Hu.DMD.Exon47.25.018 ACGGAAGAGATGGTTAATGTCTAAC 500 Hu.DMD.Exon47.20.001 ACAGACAAATGCAACAACGT 501 Hu.DMD.Exon47.20.002 CTGAAACAGACAAATGCAAC 502 Hu.DMD.Exon47.20.003 AGTAACTGAAACAGACAAAT 503 Hu.DMD.Exon47.20.004 CCACCAGTAACTGAAACAGA 504 Hu.DMD.Exon47.20.005 CTCTTCCACCAGTAACTGAA 505 Hu.DMD.Exon47.20.006 GGCAACTCTTCCACCAGTAA 506 Hu.DMD.Exon47.20.007 CTGGCGCAGGGGCAACTCTT 507 Hu.DMD.Exon47.20.008 TTGTTTGAGAATTCCCTGGC 508 Hu.DMD.Exon47.20.009 TCCAGTTTCATTTAATTGTT 509 Hu.DMD.Exon47.20.010 TACAAGCACGGGTCCTCCAG 510 Hu.DMD.Exon47.20.011 GCTTATGGGAGCACTTACAA 511 Hu.DMD.Exon47.20.012 ATCTTGCTCTTCTGGGCTTA 512 Hu.DMD.Exon47.20.013 CTTATTTTCAAGTTTATCTT 513 Hu.DMD.Exon47.20.014 ATTTGTCTGCTTGAGCTTAT 514 Hu.DMD.Exon47.20.015 CTTTATCCACTGGAGATTTG 515 Hu.DMD.Exon47.20.016 CTAACCTTTATCCACTGGAG 516 Hu.DMD.Exon47.20.017 AATGTCTAACCTTTATCCAC 517 Hu.DMD.Exon47.20.018 TGGTTAATGTCTAACCTTTA 518 Hu.DMD.Exon47.20.019 AGAGATGGTTAATGTCTAAC 519 Hu.DMD.Exon47.20.020 ACGGAAGAGATGGTTAATGT 520 Hu.DMD.Exon48.25.001 CTGAAAGGAAAATACATTTTAAAAA 521 Hu.DMD.Exon48.25.002 CCTGAAAGGAAAATACATTTTAAAA 522 Hu.DMD.Exon48.25002.2 GAAACCTGAAAGGAAAATACATTTT 523 Hu.DMD.Exon48.25.003 GGAAACCTGAAAGGAAAATACATTT 524 Hu.DMD.Exon48.25.003.2 CTCTGGAAACCTGAAAGGAAAATAC 525 Hu.DMD.Exon48.25.004 GCTCTGGAAACCTGAAAGGAAAATA 526 Hu.DMD.Exon48.25.004.2 TAAAGCTCTGGAAACCTGAAAGGAA 527 Hu.DMD.Exon48.25.005 GTAAAGCTCTGGAAACCTGAAAGGA 528 Hu.DMD.Exon48.25.005.2 TCAGGTAAAGCTCTGGAAACCTGAA 529 Hu.DMD.Exon48.25.006 CTCAGGTAAAGCTCTGGAAACCTGA 530 Hu.DMD.Exon48.25.006.2 GTTTCTCAGGTAAAGCTCTGGAAAC 531 Hu.DMD.Exon48.25.007 TGTTTCTCAGGTAAAGCTCTGGAAA 532 Hu.DMD.Exon48.25.007.2 AATTTCTCCTTGTTTCTCAGGTAAA 533 Hu.DMD.Exon48.25.008 TTTGAGCTTCAATTTCTCCTTGTTT 534 Hu.DMD.Exon48.25.008 TTTTATTTGAGCTTCAATTTCTCCT 535 Hu.DMD.Exon48.25.009 AAGCTGCCCAAGGTCTTTTATTTGA 536 Hu.DMD.Exon48.25.010 AGGTCTTCAAGCTTTTTTTCAAGCT 537 Hu.DMD.Exon48.25.010.2 TTCAAGCTTTTTTTCAAGCTGCCCA 538 Hu.DMD.Exon48.25.011 GATGATTTAACTGCTCTTCAAGGTC 539 Hu.DMD.Exon48.25.011.2 CTGCTCTTCAAGGTCTTCAAGCTTT 540 Hu.DMD.Exon48.25.012 AGGAGATAACCACAGCAGCAGATGA 541 Hu.DMD.Exon48.25.012.2 CAGCAGATGATTTAACTGCTCTTCA 542 Hu.DMD.Exon48.25.013 ATTTCCAACTGATTCCTAATAGGAG 543 Hu.DMD.Exon48.25.014 CTTGGTTTGGTTGGTTATAAATTTC 544 Hu.DMD.Exon48.25.014.2 CAACTGATTCCTAATAGGAGATAAC 545 Hu.DMD.Exon48.25.015 CTTAACGTCAAATGGTCCTTCTTGG 546 Hu.DMD.Exon48.25.015.2 TTGGTTATAAATTTCCAACTGATTC 547 Hu.DMD.Exon48.25.016 CCTACCTTAACGTCAAATGGTCCTT 548 Hu.DMD.Exon48.25.016.2 TCCTTCTTGGTTTGGTTGGTTATAA 549 Hu.DMD.Exon48.25.017 AGTTCCCTACCTTAACGTCAAATGG 550 Hu.DMD.Exon48.25.018 CAAAAAGTTCCCTACCTTAACGTCA 551 Hu.DMD.Exon48.25.019 TAAAGCAAAAAGTTCCCTACCTTAA 552 Hu.DMD.Exon48.25.020 ATATTTAAAGCAAAAAGTTCCCTAC 553 Hu.DMD.Exon48.20.001 AGGAAAATACATTTTAAAAA 554 Hu.DMD.Exon48.20.002 AAGGAAAATACATTTTAAAA 555 Hu.DMD.Exon48.20.003 CCTGAAAGGAAAATACATTT 556 Hu.DMD.Exon48.20.004 GGAAACCTGAAAGGAAAATA 557 Hu.DMD.Exon48.20.005 GCTCTGGAAACCTGAAAGGA 558 Hu.DMD.Exon48.20.006 GTAAAGCTCTGGAAACCTGA 559 Hu.DMD.Exon48.20.007 CTCAGGTAAAGCTCTGGAAA 560 Hu.DMD.Exon48.20.008 AATTTCTCCTTGTTTCTCAG 561 Hu.DMD.Exon48.20.009 TTTTATTTGAGCTTCAATTT 562 Hu.DMD.Exon48.20.010 AAGCTGCCCAAGGTCTTTTA 563 Hu.DMD.Exon48.20.011 TTCAAGCTTTTTTTCAAGCT 564 Hu.DMD.Exon48.20.012 CTGCTCTTCAAGGTCTTCAA 565 Hu.DMD.Exon48.20.013 CAGCAGATGATTTAACTGCT 566 Hu.DMD.Exon48.20.014 AGGAGATAACCACAGCAGCA 567 Hu.DMD.Exon48.20.015 CAACTGATTCCTAATAGGAG 568 Hu.DMD.Exon48.20.016 TTGGTTATAAATTTCCAACT 569 Hu.DMD.Exon48.20.017 TCCTTCTTGGTTTGGTTGGT 570 Hu.DMD.Exon48.20.018 CTTAACGTCAAATGGTCCTT 571 Hu.DMD.Exon48.20.019 CCTACCTTAACGTCAAATGG 572 Hu.DMD.Exon48.20.020 AGTTCCCTACCTTAACGTCA 573 Hu.DMD.Exon48.20.021 CAAAAAGTTCCCTACCTTAA 574 Hu.DMD.Exon48.20.022 TAAAGCAAAAAGTTCCCTAC 575 Hu.DMD.Exon48.20.023 ATATTTAAAGCAAAAAGTTC 576 Hu.DMD.Exon49.25.001 CTGGGGAAAAGAACCCATATAGTGC 577 Hu.DMD.Exon49.25.002 TCCTGGGGAAAAGAACCCATATAGT 578 Hu.DMD.Exon49.25.002.2 GTTTCCTGGGGAAAAGAACCCATAT 579 Hu.DMD.Exon49.25.003 CAGTTTCCTGGGGAAAAGAACCCAT 580 Hu.DMD.Exon49.25.003.2 TTTCAGTTTCCTGGGGAAAAGAACC 581 Hu.DMD.Exon49.25.004 TATTTCAGTTTCCTGGGGAAAAGAA 582 Hu.DMD.Exon49.25.004.2 TGCTATTTCAGTTTCCTGGGGAAAA 583 Hu.DMD.Exon49.25.005 ACTGCTATTTCAGTTTCCTGGGGAA 584 Hu.DMD.Exon49.25.005.2 TGAACTGCTATTTCAGTTTCCTGGG 585 Hu.DMD.Exon49.25.006 CTTGAACTGCTATTTCAGTTTCCTG 586 Hu.DMD.Exon49.25.006.2 TAGCTTGAACTGCTATTTCAGTTTC 587 Hu.DMD.Exon49.25.007 TTTAGCTTGAACTGCTATTTCAGTT 588 Hu.DMD.Exon49.25.008 TTCCACATCCGGTTGTTTAGCTTGA 589 Hu.DMD.Exon49.25.009 TGCCCTTTAGACAAAATCTCTTCCA 590 Hu.DMD.Exon49.25.009.2 TTTAGACAAAATCTCTTCCACATCC 591 Hu.DMD.Exon49.25.010 GTTTTTCCTTGTACAAATGCTGCCC 592 Hu.DMD.Exon49.25.010.2 GTACAAATGCTGCCCTTTAGACAAA 593 Hu.DMD.Exon49.25.011 CTTCACTGGCTGAGTGGCTGGTTTT 594 Hu.DMD.Exon49.25.011.2 GGCTGGTTTTTCCTTGTACAAATGC 595 Hu.DMD.Exon49.25.012 ATTACCTTCACTGGCTGAGTGGCTG 596 Hu.DMD.Exon49.25.013 GCTTCATTACCTTCACTGGCTGAGT 597 Hu.DMD.Exon49.25.014 AGGTTGCTTCATTACCTTCACTGGC 598 Hu.DMD.Exon49.25.015 GCTAGAGGTTGCTTCATTACCTTCA 599 Hu.DMD.Exon49.25.016 ATATTGCTAGAGGTTGCTTCATTAC 600 Hu.DMD.Exon49.20.001 GAAAAGAACCCATATAGTGC 601 Hu.DMD.Exon49.20.002 GGGAAAAGAACCCATATAGT 602 Hu.DMD.Exon49.20.003 TCCTGGGGAAAAGAACCCAT 603 Hu.DMD.Exon49.20.004 CAGTTTCCTGGGGAAAAGAA 604 Hu.DMD.Exon49.20.005 TATTTCAGTTTCCTGGGGAA 605 Hu.DMD.Exon49.20.006 ACTGCTATTTCAGTTTCCTG 606 Hu.DMD.Exon49.20.007 CTTGAACTGCTATTTCAGTT 607 Hu.DMD.Exon49.20.008 TTTAGCTTGAACTGCTATTT 608 Hu.DMD.Exon49.20.009 TTCCACATCCGGTTGTTTAG 609 Hu.DMD.Exon49.20.010 TTTAGACAAAATCTCTTCCA 610 Hu.DMD.Exon49.20.011 GTACAAATGCTGCCCTTTAG 611 Hu.DMD.Exon49.20.012 GGCTGGTTTTTCCTTGTACA 612 Hu.DMD.Exon49.20.013 CTTCACTGGCTGAGTGGCTG 613 Hu.DMD.Exon49.20.014 ATTACCTTCACTGGCTGAGT 614 Hu.DMD.Exon49.20.015 GCTTCATTACCTTCACTGGC 615 Hu.DMD.Exon49.20.016 AGGTTGCTTCATTACCTTCA 616 Hu.DMD.Exon49.20.017 GCTAGAGGTTGCTTCATTAC 617 Hu.DMD.Exon49.20.018 ATATTGCTAGAGGTTGCTTC 618 Hu.DMD.Exon50.25.001 CTTTAACAGAAAAGCATACACATTA 619 Hu.DMD.Exon50.25.002 TCCTCTTTAACAGAAAAGCATACAC 620 Hu.DMD.Exon50.25.002.2 TTCCTCTTTAACAGAAAAGCATACA 621 Hu.DMD.Exon50.25.003 TAACTTCCTCTTTAACAGAAAAGCA 622 Hu.DMD.Exon50.25.003.2 CTAACTTCCTCTTTAACAGAAAAGC 623 Hu.DMD.Exon50.25.004 TCTTCTAACTTCCTCTTTAACAGAA 624 Hu.DMD.Exon50.25.004.2 ATCTTCTAACTTCCTCTTTAACAGA 625 Hu.DMD.Exon50.25.005 TCAGATCTTCTAACTTCCTCTTTAA 626 Hu.DMD.Exon50.25.005.2 CTCAGATCTTCTAACTTCCTCTTTA 627 Hu.DMD.Exon50.25.006 AGAGCTCAGATCTTCTAACTTCCTC 628 Hu.DMD.Exon50.25.006.2 CAGAGCTCAGATCTTCTAACTTCCT 629 NG-08-0731 Hu.DMD.Exon50.25.007 CACTCAGAGCTCAGATCTTCTACT 630 Hu.DMD.Exon50.25.007.2 CCTTCCACTCAGAGCTCAGATCTTC 631 Hu.DMD.Exon50.25.008 GTAAACGGTTTACCGCCTTCCACTC 632 Hu.DMD.Exon50.25.009 CTTTGCCCTCAGCTCTTGAAGTAAA 633 Hu.DMD.Exon50.25.009.2 CCCTCAGCTCTTGAAGTAAACGGTT 634 Hu.DMD.Exon50.25.010 CCAGGAGCTAGGTCAGGCTGCTTTG 635 Hu.DMD.Exon50.25.010.2 GGTCAGGCTGCTTTGCCCTCAGCTC 636 Hu.DMD.Exon50.25.011 AGGCTCCAATAGTGGTCAGTCCAGG 637 Hu.DMD.Exon50.25.011.2 TCAGTCCAGGAGCTAGGTCAGGCTG 638 Hu.DMD.Exon50.25.012 CTTACAGGCTCCAATAGTGGTCAGT 639 AVI-5038 Hu.DMD.Exon50.25.013 GTATACTTACAGGCTCCAATAGTGG 640 Hu.DMD.Exon50.25.014 ATCCAGTATACTTACAGGCTCCAAT 641 Hu.DMD.Exon50.25.015 ATGGGATCCAGTATACTTACAGGCT 642 NG-08-0741 Hu.DMD.Exon50.25.016 AGAGAATGGGATCCAGTATACTTAC 643 NG-08-0742 Hu.DMD.Exon50.20.001 ACAGAAAAGCATACACATTA 644 Hu.DMD.Exon50.20.002 TTTAACAGAAAAGCATACAC 645 Hu.DMD.Exon50.20.003 TCCTCTTTAACAGAAAAGCA 646 Hu.DMD.Exon50.20.004 TAACTTCCTCTTTAACAGAA 647 Hu.DMD.Exon50.20.005 TCTTCTAACTTCCTCTTTAA 648 Hu.DMD.Exon50.20.006 TCAGATCTTCTAACTTCCTC 649 Hu.DMD.Exon50.20.007 CCTTCCACTCAGAGCTCAGA 650 Hu.DMD.Exon50.20.008 GTAAACGGTTTACCGCCTTC 651 Hu.DMD.Exon50.20.009 CCCTCAGCTCTTGAAGTAAA 652 Hu.DMD.Exon50.20.010 GGTCAGGCTGCTTTGCCCTC 653 Hu.DMD.Exon50.20.011 TCAGTCCAGGAGCTAGGTCA 654 Hu.DMD.Exon50.20.012 AGGCTCCAATAGTGGTCAGT 655 Hu.DMD.Exon50.20.013 CTTACAGGCTCCAATAGTGG 656 Hu.DMD.Exon50.20.014 GTATACTTACAGGCTCCAAT 657 Hu.DMD.Exon50.20.015 ATCCAGTATACTTACAGGCT 658 Hu.DMD.Exon50.20.016 ATGGGATCCAGTATACTTAC 659 Hu.DMD.Exon50.20.017 AGAGAATGGGATCCAGTATA 660 Hu.DMD.Exon51.25.001- CTAAAATATTTTGGGTTTTTGCAAAA 661 44 Hu.DMD.Exon51.25.002- GCTAAAATATTTTGGGTTTTTGCAAA 662 45 Hu.DMD.Exon51.25.002.2- TAGGAGCTAAAATATTTTGGGTTTTT 663 46 Hu.DMD.Exon51.25.003 AGTAGGAGCTAAAATATTTTGGGTT 664 Hu.DMD.Exon51.25.003.2 TGAGTAGGAGCTAAAATATTTTGGG 665 Hu.DMD.Exon51.25.004 CTGAGTAGGAGCTAAAATATTTTGGG 666 Hu.DMD.Exon51.25.004.2 CAGTCTGAGTAGGAGCTAAAATATT 667 Hu.DMD.Exon51.25.005 ACAGTCTGAGTAGGAGCTAAAATATT 668 Hu.DMD.Exon51.25.005.2 GAGTAACAGTCTGAGTAGGAGCTAAA 669 Hu.DMD.Exon51.25.006 CAGAGTAACAGTCTGAGTAGGAGCT 670 Hu.DMD.Exon51.25.006.2 CACCAGAGTAACAGTCTGAGTAGGAG 671 Hu.DMD.Exon51.25.007 GTCACCAGAGTAACAGTCTGAGTAG 672 Hu.DMD.Exon51.25.007.2 AACCACAGGTTGTGTCACCAGAGTAA 673 Hu.DMD.Exon51.25.008 GTTGTGTCACCAGAGTAACAGTCTG 674 Hu.DMD.Exon51.25.009 TGGCAGTTTCCTTAGTAACCACAGGT 675 Hu.DMD.Exon51.25.010 ATTTCTAGTTTGGAGATGGCAGTTTC 676 Hu.DMD.Exon51.25.010.2 GGAAGATGGCATTTCTAGTTTGGAG 677 Hu.DMD.Exon51.25.011 CATCAAGGAAGATGGCATTTCTAGTT 678 Hu.DMD.Exon51.25.011.2 GAGCAGGTACCTCCAACATCAAGGAA 679 Hu.DMD.Exon51.25.012 ATCTGCCAGAGCAGGTACCTCCAAC 680 Hu.DMD.Exon51.25.013 AAGTTCTGTCCAAGCCCGGTTGAAAT 681 Hu.DMD.Exon51.25.013.2 CGGTTGAAATCTGCCAGAGCAGGTAC 682 Hu.DMD.Exon51.25.014 GAGAAAGCCAGTCGGTAAGTTCTGTC 683 Hu.DMD.Exon51.25.014.2 GTCGGTAAGTTCTGTCCAAGCCCGG 684 Hu.DMD.Exon51.25.015 ATAACTTGATCAAGCAGAGAAAGCCA 685 Hu.DMD.Exon51.25.015.2 AAGCAGAGAAAGCCAGTCGGTAAGT 686 Hu.DMD.Exon51.25.016 CACCCTCTGTGATTTTATAACTTGAT 687 Hu.DMD.Exon51.25.017 CAAGGTCACCCACCATCACCCTCTGT 688 Hu.DMD.Exon51.25.017.2 CATCACCCTCTGTGATTTTATAACT 689 Hu.DMD.Exon51.25.018 CTTCTGCTTGATGATCATCTCGTTGA 690 Hu.DMD.Exon51.25.019 CCTTCTGCTTGATGATCATCTCGTTG 691 Hu.DMD.Exon51.25.019.2 ATCTCGTTGATATCCTCAAGGTCACC 692 Hu.DMD.Exon51.25.020 TCATACCTTCTGCTTGATGATCATCT 693 Hu.DMD.Exon51.25.020.2 TCATTTTTTCTCATACCTTCTGCTTG 694 Hu.DMD.Exon51.25.021 TTTTCTCATACCTTCTGCTTGATGAT 695 Hu.DMD.Exon51.25.022 TTTTATCATTTTTTCTCATACCTTCT 696 Hu.DMD.Exon51.25.023 CCAACTTTTATCATTTTTTCTCATAC 697 Hu.DMD.Exon51.20.001 ATATTTTGGGTTTTTGCAAA 698 Hu.DMD.Exon51.20.002 AAAATATTTTGGGTTTTTGC 699 Hu.DMD.Exon51.20.003 GAGCTAAAATATTTTGGGTT 700 Hu.DMD.Exon51.20.004 AGTAGGAGCTAAAATATTTT 701 Hu.DMD.Exon51.20.005 GTCTGAGTAGGAGCTAAAAT 702 Hu.DMD.Exon51.20.006 TAACAGTCTGAGTAGGAGCT 703 Hu.DMD.Exon51.20.007 CAGAGTAACAGTCTGAGTAG 704 Hu.DMD.Exon51.20.008 CACAGGTTGTGTCACCAGAG 705 Hu.DMD.Exon51.20.009 AGTTTCCTTAGTAACCACAG 706 Hu.DMD.Exon51.20.010 TAGTTTGGAGATGGCAGTTT 707 Hu.DMD.Exon51.20.011 GGAAGATGGCATTTCTAGTT 708 Hu.DMD.Exon51.20.012 TACCTCCAACATCAAGGAAG 709 Hu.DMD.Exon51.20.013 ATCTGCCAGAGCAGGTACCT 710 Hu.DMD.Exon51.20.014 CCAAGCCCGGTTGAAATCTG 711 Hu.DMD.Exon51.20.015 GTCGGTAAGTTCTGTCCAAG 712 Hu.DMD.Exon51.20.016 AAGCAGAGAAAGCCAGTCGG 713 Hu.DMD.Exon51.20.017 TTTTATAACTTGATCAAGCA 714 Hu.DMD.Exon51.20.018 CATCACCCTCTGTGATTTTA 715 Hu.DMD.Exon51.20.019 CTCAAGGTCACCCACCATCA 716 Hu.DMD.Exon51.20.020 CATCTCGTTGATATCCTCAA 717 Hu.DMD.Exon51.20.021 CTTCTGCTTGATGATCATCT 718 Hu.DMD.Exon51.20.022 CATACCTTCTGCTTGATGAT 719 Hu.DMD.Exon51.20.023 TTTCTCATACCTTCTGCTTG 720 Hu.DMD.Exon51.20.024 CATTTTTTCTCATACCTTCT 721 Hu.DMD.Exon51.20.025 TTTATCATTTTTTCTCATAC 722 Hu.DMD.Exon51.20.026 CAACTTTTATCATTTTTTCT 723 Hu.DMD.Exon52.25.001 CTGTAAGAACAAATATCCCTTAGTA 724 Hu.DMD.Exon52.25.002 TGCCTGTAAGAACAAATATCCCTTA 725 Hu.DMD.Exon52.25.002.2 GTTGCCTGTAAGAACAAATATCCCT 726 Hu.DMD.Exon52.25.003 ATTGTTGCCTGTAAGAACAAATATC 727 Hu.DMD.Exon52.25.003.2 GCATTGTTGCCTGTAAGAACAAATA 728 Hu.DMD.Exon52.25.004 CCTGCATTGTTGCCTGTAAGAACAA 729 Hu.DMD.Exon52.25.004.2 ATCCTGCATTGTTGCCTGTAAGAAC 730 Hu.DMD.Exon52.25.005 CAAATCCTGCATTGTTGCCTGTAAG 731 Hu.DMD.Exon52.25.005.2 TCCAAATCCTGCATTGTTGCCTGTA 732 Hu.DMD.Exon52.25.006 TGTTCCAAATCCTGCATTGTTGCCT 733 Hu.DMD.Exon52.25.006.2 TCTGTTCCAAATCCTGCATTGTTGC 734 Hu.DMD.Exon52.25.007 AACTGGGGACGCCTCTGTTCCAAAT 735 Hu.DMD.Exon52.25.007.2 GCCTCTGTTCCAAATCCTGCATTGT 736 Hu.DMD.Exon52.25.008 CAGCGGTAATGAGTTCTTCCAACTG 737 Hu.DMD.Exon52.25.008.2 CTTCCAACTGGGGACGCCTCTGTTC 738 Hu.DMD.Exon52.25.009 CTTGTTTTTCAAATTTTGGGCAGCG 739 Hu.DMD.Exon52.25.010 CTAGCCTCTTGATTGCTGGTCTTGT 740 Hu.DMD.Exon52.25.010.2 TTTTCAAATTTTGGGCAGCGGTAAT 741 Hu.DMD.Exon52.25.011 TTCGATCCGTAATGATTGTTCTAGC 742 Hu.DMD.Exon52.25.011.2 GATTGCTGGTCTTGTTTTTCAAATT 743 Hu.DMD.Exon52.25.012 CTTACTTCGATCCGTAATGATTGTT 744 Hu.DMD.Exon52.25.012.2 TTGTTCTAGCCTCTTGATTGCTGGT 745 Hu.DMD.Exon52.25.013 AAAAACTTACTTCGATCCGTAATGA 746 Hu.DMD.Exon52.25.014 TGTTAAAAAACTTACTTCGATCCGT 747 Hu.DMD.Exon52.25.015 ATGCTTGTTAAAAAACTTACTTCGA 748 Hu.DMD.Exon52.25.016 GTCCCATGCTTGTTAAAAAACTTAC 749 Hu.DMD.Exon52.20.001 AGAACAAATATCCCTTAGTA 750 Hu.DMD.Exon52.20.002 GTAAGAACAAATATCCCTTA 751 Hu.DMD.Exon52.20.003 TGCCTGTAAGAACAAATATC 752 Hu.DMD.Exon52.20.004 ATTGTTGCCTGTAAGAACAA 753 Hu.DMD.Exon52.20.005 CCTGCATTGTTGCCTGTAAG 754 Hu.DMD.Exon52.20.006 CAAATCCTGCATTGTTGCCT 755 Hu.DMD.Exon52.20.007 GCCTCTGTTCCAAATCCTGC 756 Hu.DMD.Exon52.20.008 CTTCCAACTGGGGACGCCTC 757 Hu.DMD.Exon52.20.009 CAGCGGTAATGAGTTCTTCC 758 Hu.DMD.Exon52.20.010 TTTTCAAATTTTGGGCAGCG 759 Hu.DMD.Exon52.20.011 GATTGCTGGTCTTGTTTTTC 760 Hu.DMD.Exon52.20.012 TTGTTCTAGCCTCTTGATTG 761 Hu.DMD.Exon52.20.013 TTCGATCCGTAATGATTGTT 762 Hu.DMD.Exon52.20.014 CTTACTTCGATCCGTAATGA 763 Hu.DMD.Exon52.20.015 AAAAACTTACTTCGATCCGT 764 Hu.DMD.Exon52.20.016 TGTTAAAAAACTTACTTCGA 765 Hu.DMD.Exon52.20.017 ATGCTTGTTAAAAAACTTAC 766 Hu.DMD.Exon52.20.018 GTCCCATGCTTGTTAAAAAA 767 Hu.DMD.Exon53.25.001 CTAGAATAAAAGGAAAAATAAATAT 768 Hu.DMD.Exon53.25.002 AACTAGAATAAAAGGAAAAATAAAT 769 Hu.DMD.Exon53.25.002.2 TTCAACTAGAATAAAAGGAAAAATA 770 Hu.DMD.Exon53.25.003 CTTTCAACTAGAATAAAAGGAAAAA 771 Hu.DMD.Exon53.25.003.2 ATTCTTTCAACTAGAATAAAAGGAA 772 Hu.DMD.Exon53.25.004 GAATTCTTTCAACTAGAATAAAAGG 773 Hu.DMD.Exon53.25.004.2 TCTGAATTCTTTCAACTAGAATAAA 774 Hu.DMD.Exon53.25.005 ATTCTGAATTCTTTCAACTAGAATA 775 Hu.DMD.Exon53.25.005.2 CTGATTCTGAATTCTTTCAACTAGA 776 Hu.DMD.Exon53.25.006 CACTGATTCTGAATTCTTTCAACTA 777 Hu.DMD.Exon53.25.006.2 TCCCACTGATTCTGAATTCTTTCAA 778 Hu.DMD.Exon53.25.007 CATCCCACTGATTCTGAATTCTTTC 779 Hu.DMD.Exon53.25.008 TACTTCATCCCACTGATTCTGAATT 780 Hu.DMD.Exon53.25.008.2 CTGAAGGTGTTCTTGTACTTCATCC 781 Hu.DMD.Exon53.25.009 CGGTTCTGAAGGTGTTCTTGTACT 782 Hu.DMD.Exon53.25.009.2 CTGTTGCCTCCGGTTCTGAAGGTGT 783 Hu.DMD.Exon53.25.010 TTTCATTCAACTGTTGCCTCCGGTT 784 Hu.DMD.Exon53.25.010.2 TAACATTTCATTCAACTGTTGCCTC 785 Hu.DMD.Exon53.25.011 TTGTGTTGAATCCTTTAACATTTCA 786 Hu.DMD.Exon53.25.012 TCTTCCTTAGCTTCCAGCCATTGTG 787 Hu.DMD.Exon53.25.012.2 CTTAGCTTCCAGCCATTGTGTTGAA 788 Hu.DMD.Exon53.25.013 GTCCTAAGACCTGCTCAGCTTCTTC 789 Hu.DMD.Exon53.25.013.2 CTGCTCAGCTTCTTCCTTAGCTTCC 790 Hu.DMD.Exon53.25.014 CTCAAGCTTGGCTCTGGCCTGTCCT 791 Hu.DMD.Exon53.25.014.2 GGCCTGTCCTAAGACCTGCTCAGCT 792 Hu.DMD.Exon53.25.015 TAGGGACCCTCCTTCCATGACTCAA 793 Hu.DMD.Exon53.25.016 TTTGGATTGCATCTACTGTATAGGG 794 Hu.DMD.Exon53.25.016.2 ACCCTCCTTCCATGACTCAAGCTTG 795 Hu.DMD.Exon53.25.017 CTTGGTTTCTGTGATTTTCTTTTGG 796 Hu.DMD.Exon53.25.017.2 ATCTACTGTATAGGGACCCTCCTTC 797 Hu.DMD.Exon53.25.018 CTAACCTTGGTTTCTGTGATTTTCT 798 Hu.DMD.Exon53.25.018.2 TTTCTTTTGGATTGCATCTACTGTA 799 Hu.DMD.Exon53.25.019 TGATACTAACCTTGGTTTCTGTGAT 800 Hu.DMD.Exon53.25.020 ATCTTTGATACTAACCTTGGTTTCT 801 Hu.DMD.Exon53.25.021 AAGGTATCTTTGATACTAACCTTGG 802 Hu.DMD.Exon53.25.022 TTAAAAAGGTATCTTTGATACTAAC 803 Hu.DMD.Exon53.20.001 ATAAAAGGAAAAATAAATAT 804 Hu.DMD.Exon53.20.002 GAATAAAAGGAAAAATAAAT 805 Hu.DMD.Exon53.20.003 AACTAGAATAAAAGGAAAAA 806 Hu.DMD.Exon53.20.004 CTTTCAACTAGAATAAAAGG 807 Hu.DMD.Exon53.20.005 GAATTCTTTCAACTAGAATA 808 Hu.DMD.Exon53.20.006 ATTCTGAATTCTTTCAACTA 809 Hu.DMD.Exon53.20.007 TACTTCATCCCACTGATTCT 810 Hu.DMD.Exon53.20.008 CTGAAGGTGTTCTTGTACT 811 Hu.DMD.Exon53.20.009 CTGTTGCCTCCGGTTCTGAA 812 Hu.DMD.Exon53.20.010 TAACATTTCATTCAACTGTT 813 Hu.DMD.Exon53.20.011 TTGTGTTGAATCCTTTAACA 814 Hu.DMD.Exon53.20.012 CTTAGCTTCCAGCCATTGTG 815 Hu.DMD.Exon53.20.013 CTGCTCAGCTTCTTCCTTAG 816 Hu.DMD.Exon53.20.014 GGCCTGTCCTAAGACCTGCT 817 Hu.DMD.Exon53.20.015 CTCAAGCTTGGCTCTGGCCT 818 Hu.DMD.Exon53.20.016 ACCCTCCTTCCATGACTCAA 819 Hu.DMD.Exon53.20.017 ATCTACTGTATAGGGACCCT 820 Hu.DMD.Exon53.20.018 TTTCTTTTGGATTGCATCTA 821 Hu.DMD.Exon53.20.019 CTTGGTTTCTGTGATTTTCT 822 Hu.DMD.Exon53.20.020 CTAACCTTGGTTTCTGTGAT 823 Hu.DMD.Exon53.20.021 TGATACTAACCTTGGTTTCT 824 Hu.DMD.Exon53.20.022 ATCTTTGATACTAACCTTGG 825 Hu.DMD.Exon53.20.023 AAGGTATCTTTGATACTAAC 826 Hu.DMD.Exon53.20.024 TTAAAAAGGTATCTTTGATA 827 Hu.DMD.Exon54.25.001 CTATAGATTTTTATGAGAAAGAGA 828 Hu.DMD.Exon54.25.002 AACTGCTATAGATTTTTATGAGAAA 829 Hu.DMD.Exon54.25.003 TGGCCAACTGCTATAGATTTTTATG 830 Hu.DMD.Exon54.25.004 GTCTTTGGCCAACTGCTATAGATTT 831 Hu.DMD.Exon54.25.005 CGGAGGTCTTTGGCCAACTGCTATA 832 Hu.DMD.Exon54.25.006 ACTGGCGGAGGTCTTTGGCCAACTG 833 Hu.DMD.Exon54.25.007 TTTGTCTGCCACTGGCGGAGGTCTT 834 Hu.DMD.Exon54.25.008 AGTCATTTGCCACATCTACATTTGT 835 Hu.DMD.Exon54.25.008.2 TTTGCCACATCTACATTTGTCTGCC 836 Hu.DMD.Exon54.25.009 CCGGAGAAGTTTCAGGGCCAAGTCA 837 Hu.DMD.Exon54.25.010 GTATCATCTGCAGAATAATCCCGGA 838 Hu.DMD.Exon54.25.010.2 TAATCCCGGAGAAGTTTCAGGGCCA 839 Hu.DMD.Exon54.25.011 TTATCATGTGGACTTTTCTGGTATC 840 Hu.DMD.Exon54.25.012 AGAGGCATTGATATTCTCTGTTATC 841 Hu.DMD.Exon54.25.012.2 ATGTGGACTTTTCTGGTATCATCTG 842 Hu.DMD.Exon54.25.013 CTTTTATGAATGCTTCTCCAAGAGG 843 Hu.DMD.Exon54.25.013.2 ATATTCTCTGTTATCATGTGGACTT 844 Hu.DMD.Exon54.25.014 CATACCTTTTATGAATGCTTCTCCA 845 Hu.DMD.Exon54.25.014.2 CTCCAAGAGGCATTGATATTCTCTG 846 Hu.DMD.Exon54.25.015 TAATTCATACCTTTTATGAATGCTT 847 Hu.DMD.Exon54.25.015.2 CTTTTATGAATGCTTCTCCAAGAGG 848 Hu.DMD.Exon54.25.016 TAATGTAATTCATACCTTTTATGAA 849 Hu.DMD.Exon54.25.017 AGAAATAATGTAATTCATACCTTTT 850 Hu.DMD.Exon54.25.018 GTTTTAGAAATAATGTAATTCATAC 851 Hu.DMD.Exon54.20.001 GATTTTTATGAGAAAGAGA 852 Hu.DMD.Exon54.20.002 CTATAGATTTTTATGAGAAA 853 Hu.DMD.Exon54.20.003 AACTGCTATAGATTTTTATG 854 Hu.DMD.Exon54.20.004 TGGCCAACTGCTATAGATTT 855 Hu.DMD.Exon54.20.005 GTCTTTGGCCAACTGCTATA 856 Hu.DMD.Exon54.20.006 CGGAGGTCTTTGGCCAACTG 857 Hu.DMD.Exon54.20.007 TTTGTCTGCCACTGGCGGAG 858 Hu.DMD.Exon54.20.008 TTTGCCACATCTACATTTGT 859 Hu.DMD.Exon54.20.009 TTCAGGGCCAAGTCATTTGC 860 Hu.DMD.Exon54.20.010 TAATCCCGGAGAAGTTTCAG 861 Hu.DMD.Exon54.20.011 GTATCATCTGCAGAATAATC 862 Hu.DMD.Exon54.20.012 ATGTGGACTTTTCTGGTATC 863 Hu.DMD.Exon54.20.013 ATATTCTCTGTTATCATGTG 864 Hu.DMD.Exon54.20.014 CTCCAAGAGGCATTGATATT 865 Hu.DMD.Exon54.20.015 CTTTTATGAATGCTTCTCCA 866 Hu.DMD.Exon54.20.016 CATACCTTTTATGAATGCTT 867 Hu.DMD.Exon54.20.017 TAATTCATACCTTTTATGAA 868 Hu.DMD.Exon54.20.018 TAATGTAATTCATACCTTTT 869 Hu.DMD.Exon54.20.019 AGAAATAATGTAATTCATAC 870 Hu.DMD.Exon54.20.020 GTTTTAGAAATAATGTAATT 871 Hu.DMD.Exon55.25.001 CTGCAAAGGACCAAATGTTCAGATG 872 Hu.DMD.Exon55.25.002 TCACCCTGCAAAGGACCAAATGTTC 873 Hu.DMD.Exon55.25.003 CTCACTCACCCTGCAAAGGACCAAA 874 Hu.DMD.Exon55.25.004 TCTCGCTCACTCACCCTGCAAAGGA 875 Hu.DMD.Exon55.25.005 CAGCCTCTCGCTCACTCACCCTGCA 876 Hu.DMD.Exon55.25.006 CAAAGCAGCCTCTCGCTCACTCACC 877 Hu.DMD.Exon55.25.007 TCTTCCAAAGCAGCCTCTCGCTCAC 878 Hu.DMD.Exon55.25.007.2 TCTATGAGTTTCTTCCAAAGCAGCC 879 Hu.DMD.Exon55.25.008 GTTGCAGTAATCTATGAGTTTCTTC 880 Hu.DMD.Exon55.25.008.2 GAACTGTTGCAGTAATCTATGAGTT 881 Hu.DMD.Exon55.25.009 TTCCAGGTCCAGGGGGAACTGTTGC 882 Hu.DMD.Exon55.25.010 GTAAGCCAGGCAAGAAACTTTTCCA 883 Hu.DMD.Exon55.25.010.2 CCAGGCAAGAAACTTTTCCAGGTCC 884 Hu.DMD.Exon55.25.011 TGGCAGTTGTTTCAGCTTCTGTAAG 885 Hu.DMD.Exon55.25.011.2 TTCAGCTTCTGTAAGCCAGGCAAGA 886 Hu.DMD.Exon55.25.012 GGTAGCATCCTGTAGGACATTGGCA 887 Hu.DMD.Exon55.25.012.2 GACATTGGCAGTTGTTTCAGCTTCT 888 Hu.DMD.Exon55.25.013 TCTAGGAGCCTTTCCTTACGGGTAG 889 Hu.DMD.Exon55.25.014 CTTTTACTCCCTTGGAGTCTTCTAG 890 Hu.DMD.Exon55.25.014.2 GAGCCTTTCCTTACGGGTAGCATCC 891 Hu.DMD.Exon55.25.015 TTGCCATTGTTTCATCAGCTCTTTT 892 Hu.DMD.Exon55.25.015.2 CTTGGAGTCTTCTAGGAGCCTTTCC 893 Hu.DMD.Exon55.25.016 CTTACTTGCCATTGTTTCATCAGCT 894 Hu.DMD.Exon55.25.016.2 CAGCTCTTTTACTCCCTTGGAGTCT 895 Hu.DMD.Exon55.25.017 CCTGACTTACTTGCCATTGTTTCAT 896 Hu.DMD.Exon55.25.018 AAATGCCTGACTTACTTGCCATTGT 897 Hu.DMD.Exon55.25.019 AGCGGAAATGCCTGACTTACTTGCC 898 Hu.DMD.Exon55.25.020 GCTAAAGCGGAAATGCCTGACTTAC 899 Hu.DMD.Exon55.20.001 AAGGACCAAATGTTCAGATG 900 Hu.DMD.Exon55.20.002 CTGCAAAGGACCAAATGTTC 901 Hu.DMD.Exon55.20.003 TCACCCTGCAAAGGACCAAA 902 Hu.DMD.Exon55.20.004 CTCACTCACCCTGCAAAGGA 903 Hu.DMD.Exon55.20.005 TCTCGCTCACTCACCCTGCA 904 Hu.DMD.Exon55.20.006 CAGCCTCTCGCTCACTCACC 905 Hu.DMD.Exon55.20.007 CAAAGCAGCCTCTCGCTCAC 906 Hu.DMD.Exon55.20.008 TCTATGAGTTTCTTCCAAAG 907 Hu.DMD.Exon55.20.009 GAACTGTTGCAGTAATCTAT 908 Hu.DMD.Exon55.20.010 TTCCAGGTCCAGGGGGAACT 909 Hu.DMD.Exon55.20.011 CCAGGCAAGAAACTTTTCCA 910 Hu.DMD.Exon55.20.012 TTCAGCTTCTGTAAGCCAGG 911 Hu.DMD.Exon55.20.013 GACATTGGCAGTTGTTTCAG 912 Hu.DMD.Exon55.20.014 GGTAGCATCCTGTAGGACAT 913 Hu.DMD.Exon55.20.015 GAGCCTTTCCTTACGGGTAG 914 Hu.DMD.Exon55.20.016 CTTGGAGTCTTCTAGGAGCC 915 Hu.DMD.Exon55.20.017 CAGCTCTTTTACTCCCTTGG 916 Hu.DMD.Exon55.20.018 TTGCCATTGTTTCATCAGCT 917 Hu.DMD.Exon55.20.019 CTTACTTGCCATTGTTTCAT 918 Hu.DMD.Exon55.20.020 CCTGACTTACTTGCCATTGT 919 Hu.DMD.Exon55.20.021 AAATGCCTGACTTACTTGCC 920 Hu.DMD.Exon55.20.022 AGCGGAAATGCCTGACTTAC 921 Hu.DMD.Exon55.20.023 GCTAAAGCGGAAATGCCTGA 922 H50A(+02 + 30)-AVI-5656 CCACTCAGAGCTCAGATCTTCTAACTTCC 923 H50D(+07 − 18)-AVI-5915 GGGATCCAGTATACTTACAGGCTCC 924 H50A(+07 + 33) CTTCCACTCAGAGCTCAGATCTTCTAA 925 H51A(+61 + 90)-AVI-4657 ACATCAAGGAAGATGGCATTTCTAGTTTGG 926 H51A(+66 + 95)-AVI-4658 CTCCAACATCAAGGAAGATGGCATTTCTAG 927 H51A(+111 + 134) TTCTGTCCAAGCCCGGTTGAAATC 928 H51A(+175 + 195) CACCCACCATCACCCTCYGTG 929 H51A(+199 + 220) ATCATCTCGTTGATATCCTCAA 930 H51A(+66 + 90) ACATCAAGGAAGATGGCATTTCTAG 931 H51A(−01 + 25) ACCAGAGTAACAGTCTGAGTAGGAGC 932 h51AON1 TCAAGGAAGATGGCATTTCT 933 h51A0N2 CCTCTGTGATTTTATAACTTGAT 934 H51D(+08 − 17) ATCATTTTTTCTCATACCTTCTGCT 935 H51D(+16 − 07) CTCATACCTTCTGCTTGATGATC 936 hAON#23 TGGCATTTCTAGTTTGG 937 hAON#24 CCAGAGCAGGTACCTCCAACATC 938 H44A(+61 + 84) TGTTCAGCTTCTGTTAGCCACTGA 939 H44A(+85 + 104) TTTGTGTCTTTCTGAGAAAC 940 h44AON1 CGCCGCCATTTCTCAACAG 941 H44A(−06 + 14) ATCTGTCAAATCGCCTGCAG 942 H45A(+71 + 90) TGTTTTTGAGGATTGCTGAA 943 h45AON1 GCTGAATTATTTCTTCCCC 944 h45AON5 GCCCAATGCCATCCTGG 945 H45A(−06 + 20) CCAATGCCATCCTGGAGTTCCTGTAA 946 H53A(+39 + 69) CATTCAACTGTTGCCTCCGGTTCTGAAGGTG 947 H53A(+23 + 47) CTGAAGGTGTTCTTGTACTTCATCC 948 h53AON1 CTGTTGCCTCCGGTTCTG 949 H53A(−12 + 10) ATTCTTTCAACTAGAATAAAAG 950 huEx45.30.66 GCCATCCTGGAGTTCCTGTAAGATACCAAA 951 huEx45.30.71 CCAATGCCATCCTGGAGTTCCTGTAAGATA 952 huEx45.30.79 GCCGCTGCCCAATGCCATCCTGGAGTTCCT 953 huEx45.30.83 GTTTGCCGCTGCCCAATGCCATCCTGGAGT 954 huEx45.30.88 CAACAGTTTGCCGCTGCCCAATGCCATCCT 955 huEx45.30.92 CTGACAACAGTTTGCCGCTGCCCAATGCCA 956 huEx45.30.96 TGTTCTGACAACAGTTTGCCGCTGCCCAAT 957 huEx45.30.99 CAATGTTCTGACAACAGTTTGCCGCTGCCC 958 huEx45.30.103 CATTCAATGTTCTGACAACAGTTTGCCGCT 959 huEx45.30.120 TATTTCTTCCCCAGTTGCATTCAATGTTCT 960 huEx45.30.127 GCTGAATTATTTCTTCCCCAGTTGCATTCA 961 huEx45.30.132 GGATTGCTGAATTATTTCTTCCCCAGTTGC 962 huEx45.30.137 TTTGAGGATTGCTGAATTATTTCTTCCCCA 963 huEx53.30.84 GTACTTCATCCCACTGATTCTGAATTCTTT 964 huEx53.30.88 TCTTGTACTTCATCCCACTGATTCTGAATT 965 huEx53.30.91 TGTTCTTGTACTTCATCCCACTGATTCTGA 966 huEx53.30.103 CGGTTCTGAAGGTGTTCTTGTACTTCATCC 967 huEx53.30.106 CTCCGGTTCTGAAGGTGTTCTTGTACTTCA 968 huEx53.30.109 TGCCTCCGGTTCTGAAGGTGTTCTTGTACT 969 huEx53.30.112 TGTTGCCTCCGGTTCTGAAGGTGTTCTTGT 970 huEx53.30.115 AACTGTTGCCTCCGGTTCTGAAGGTGTTCT 971 huEx53.30.118 TTCAACTGTTGCCTCCGGTTCTGAAGGTGT 972

Step 1: Antibody Conjugation with Maleimide-PEG-NHS Followed by siRNA-DMD Conjugates

Anti-dystrophin antibody is exchanged with 1× Phosphate buffer (pH 7.4) and made up to 5 mg/ml concentration. To this solution, 2 equivalents of SMCC linker or maleimide-PEGxkDa-NHS (x=1, 5, 10, 20) is added and rotated for 4 hours at room temperature. Unreacted maleimide-PEG is removed by spin filtration using 50 kDa MWCO Amicon spin filters and PBS pH 7.4. The antibody-PEG-Mal conjugate is collected and transferred into a reaction vessel. Various siRNA conjugates are synthesized using sequences listed in Tables 13-17. siRNA-DMD conjugates (2 equivalents) is added at RT to the antibody-PEG-maleimide in PBS and rotated overnight. The reaction mixture is analyzed by analytical SAX column chromatography and conjugate along with unreacted antibody and siRNA is seen.

Step 2: Purification

The crude reaction mixture is purified by AKTA explorer FPLC using anion exchange chromatography. Fractions containing the antibody-PEG-DMD conjugate are pooled, concentrated and buffer exchanged with PBS, pH 7.4. Antibody siRNA conjugates with SMCC linker, PEG1 kDa, PEG5 kDa and PEG10 kDa are separated based on the siRNA loading.

Step-3: Analysis of the Purified Conjugate

The isolated conjugate is characterized by either mass spec or SDS-PAGE. The purity of the conjugate is assessed by analytical HPLC using anion exchange chromatography.

The examples and embodiments described herein are for illustrative purposes only and various modifications or changes suggested to persons skilled in the art are to be included within the spirit and purview of this application and scope of the appended claims. 

What is claimed is:
 1. A method of inducing exon skipping in a targeted pre-mRNA transcript of DMD gene, comprising: a) contacting a muscle cell with a phosphorodiamidate morpholino oligonucleotide (PMO) conjugate, wherein the PMO conjugate comprises an anti-transferrin receptor antibody or antigen binding fragment thereof, and a PMO targeting an acceptor splice site, a donor splice site, or an exonic splice enhancer element of the targeted pre-mRNA transcript of the DMD gene; wherein the PMO induces exon skipping in the targeted pre-mRNA transcript, and wherein the PMO conjugate is preferentially delivered into the muscle cell; b) hybridizing the PMO to the targeted pre-mRNA transcript to induce exon skipping in the targeted pre-mRNA transcript; and c) translating a mRNA transcript produced from the targeted pre-mRNA transcript processed in step b) in the muscle cell to generate a truncated DMD protein.
 2. The method of claim 1, wherein the PMO induces skipping of exon 8 of the DMD gene.
 3. The method of claim 1, wherein the PMO induces skipping of exon 23 of the DMD gene.
 4. The method of claim 1, wherein the PMO induces skipping of exon 35 of the DMD gene.
 5. The method of claim 1, wherein the PMO induces skipping of exon 43 of the DMD gene.
 6. The method of claim 1, wherein the PMO induces skipping of exon 44 of the DMD gene.
 7. The method of claim 1, wherein the PMO induces skipping of exon 45 of the DMD gene.
 8. The method of claim 1, wherein the PMO induces skipping of exon 53 of the DMD gene.
 9. The method of claim 1, wherein the PMO induces skipping of exon 50 of the DMD gene.
 10. The method of claim 1, wherein the PMO induces skipping of exon 51 of the DMD gene.
 11. The method of claim 1, wherein the PMO induces skipping of exon 52 of the DMD gene.
 12. The method of claim 1, wherein the PMO induces skipping of exon 55 of the DMD gene.
 13. The method of claim 1, wherein the antibody or antigen binding fragment thereof comprises a humanized antibody or antigen binding fragment thereof, chimeric antibody or antigen binding fragment thereof, monoclonal antibody or antigen binding fragment thereof, monovalent Fab′, divalent Fab2, single chain variable fragment (scFv), diabody, minibody, nanobody, single-domain antibody (sdAb), or camelid antibody or antigen binding fragment thereof.
 14. The method of claim 1, wherein the PMO comprises at least from about 10 to about 30 nucleotides in length.
 15. The method of claim 1, wherein the PMO comprises at least 90%, 95%, 99%, or 100% sequence identity to a sequence selected from SEQ ID NOs: 225-227, 252-263, 268-272, 352-427, 768-827, and 939-972.
 16. The method of claim 1, wherein the PMO comprises at least 90%, 95%, 99%, or 100% sequence identity to a sequence selected from SEQ ID NOs: 352-427 and 768-827.
 17. The method of claim 1, wherein the PMO is conjugated to the antibody or antigen binding fragment thereof via a linker.
 18. The method of claim 17, wherein the linker is a cleavable linker.
 19. The method of claim 17, wherein the linker is a non-cleavable linker.
 20. The method of claim 17, wherein the linker is selected from the group consisting of a heterobifunctional linker, a homobifunctional linker, a maleimide group, a dipeptide moiety, a benzoic acid group or derivatives thereof, a C₁-C₆ alkyl group, and a combination thereof.
 21. The method of claim 1, wherein the PMO conjugate has a PMO to antibody ratio of about 1:1, 2:1, 3:1, or 4:1.
 22. The method of claim 1, wherein the method is an in vivo method. 